我国城乡医疗服务质量影响因素研究

Research on the Determinants of Healthcare Service Quality in Urban and Rural China

摘要: 本研究旨在探究我国城乡医疗服务质量的主要影响因素，并揭示其中的城乡差异。基于整合的中国家庭追踪调查数据，构建医疗服务质量评价指标体系，采用熵值法计算综合质量得分，并运用多元线性回归模型对其影响因素进行分析。研究结果表明，我国城乡居民医疗服务质量的影响因素存在显著差异。性别、学历、是否患有慢性病以及就诊机构类型等外部个体因素对医疗服务质量具有显著影响，而雇主是否提供医保与服务质量之间无显著关联。在技术层面，城乡医疗资源配置对居民的服务质量感知具有关键作用，三级医院数量、门诊费用及基层医疗机构数量等因素与服务质量密切相关。基于上述发现，建议政府加大对农村及欠发达地区医疗资源的投入，提升基层医疗服务能力，推动实现城乡医疗服务的公平与质量同步提升。

Abstract: This study aims to explore the key determinants of healthcare service quality in urban and rural China and to reveal the disparities between the two. Based on integrated data from the China Family Panel Studies (CFPS), a healthcare service quality evaluation index system was constructed. The entropy weight method was employed to calculate a comprehensive quality score, followed by multiple linear regression analysis to identify influencing factors. The results indicate significant differences in the determinants of healthcare service quality between urban and rural areas. Individual-level factors such as gender, educational attainment, presence of chronic diseases, and type of healthcare institution significantly affect perceived service quality, while employer-provided health insurance shows no significant association. At the technical level, regional healthcare resource allocation plays a crucial role. The number of tertiary hospitals, outpatient costs, and the availability of primary care facilities are all significantly related to perceived service quality. These findings suggest that increased investment in rural and underdeveloped regions and enhancement of primary healthcare services are essential to promoting equity and improving the overall quality of healthcare services across urban and rural areas.