An Study On Influencing Actor Of Residents' Utilization Of Primary Health Service

under the background of Healthy China,the establishment of hierarchical medical system and first diagnosis of primary medical institutions has become an important part of the grassroots health care services system improvement.The poor Health service capacity of primary health care institutions restricts the development of primary diagnosis in the institutions.This Study Used the cross sectional data of China Health and Nutrition Survey(or CHNS)in 2011,.chose four types of factors which might affected utilization of primary health service according to Andersen behavior model of health service utilization.The article set measurement model taking example by Two-Part Models,built consultation rate model of Primary health care institutions In the first stage,which used two-category Logit model to empirical analyze on the consultation choice of Primary health care institutions;built medical costs model of Primary health care institutions In the first stage,which used Ordinary Least Square model to empirical analyze on the medical costs of Primary health care institutions.Through analysis on the consultation rate model and medical costs model of primary health care institutions,the study found out these results.(1)Demographic characteristics aspect.the Female and highly educated resident prefer to go to hospital when feel sick in the consultation rate model.The aged'outpatient expenditure of primary health care institutions is much higher than others in the medical costs model,so does highly educated resident.(2)Social and economic aspect.The variable area has significant effects in both models.The eastern resident' utilization of primary health service better than the western resident.Especially,urban residents in east are more than which in west on utilization of primary health service,but there is no difference in rural resident.The variable income were not significant in both models.(3)Health care aspect.Rural resident under the new rural cooperative medical care system prefers to consult in primary health care institutions,but their outpatient expenditure didn't grow with the increased consultation rate.Only the urban residents' basic medical insurance has significant influence on outpatient expenditure in medical costs model of primary health care institutions.While the other variables,such as self-paid ratio,medical expenses have reverse affect on consultation rate of primary health care institutions.people prefer choose to primary health care institutions when they need outpatient treatment instead of hospitalization.(4)health condition aspect.The two variables,including chronic condition and severity of illness,pass the significance test in both models.The article deduced the following conclusions according to empirical result:Quality of primary care is the key factor of utilization of primary health service.The effect of medical service price on the utilization of primary health service is limited.People who had common diseases and chronic diseases would used more service in primary health care institutions.To increasing the utilization efficiency of primary health service,promoting the residents chose primary health care institutions willingly,combining the empirical conclusions and the public goods theory,the equalization of health services,the article put forward the following targeted suggestions:through strengthening the financial and policies support to improve service capability and quality of primary health care institutions;Increasing compensation when resident chosen consultation in primary health care institutions;pushing forward management of chronic disease and general practitioner system in primary health care institutions.