An Theoretical And Empirical Study On Medical Consumption Behavior In Citizens

BackgroundAfter the reform and opening of China, the average income and consumption expenditure have been increasing continuously. The consumption structure is becoming better and the consumption quality rises dramatically. The mode of consumption structure and concept has transited from traditional basic to developing and enjoying.The medical consumption behavior also changed significantly and the medical expenditure increases sharply. The increasing rate of health expenditure of the whole society is far higher than that of the GDP. And this has reached to an extent that is not tolerable to the country, organizations or individuals. The availability to the health service is compromised correspondingly. The rapid increase of the medical expenditure is an internationally tough problem. Nevertheless, to analyze the influencing factors and mechanism of the medial expenditure will have meaningful significance to control the medical expenditure.With the deepening medical system reform of Hangzhou, the arrangement of the hospital planning has adjusted and the medical market is developing to a multiple way. The medical expenditure behavior of the citizens also shows a manner of multiplicity. Hence, it would be helpful to the medical service units to establish corresponding service according to their specialties and lock their markets bystudying the internal rules and risk factors of the medial consumption behavior.AimsTo set up a model of medical consumption behavior based on the theoretical studying and to further testify and correct the model by investigating of the Hangzhou citizens; to give marketing reference to related medial units by describing the medical expenditure behavior of Hangzhou citizens of different background and characteristics; to give scientific evidence and reference for the policy making department and to help the reform of the medical system smoothly.MethodsThe combination of theoretical with empirical study was the main research method.1.Theoretical researchTo set up a model of medical consumption behavior based on the theoretical studying.2. Empirical researchTo testify and correct the medical consumption behavior model by empirical investigating of the health seeking behavior in Hangzhou citizens.(1) Subjects: Hangzhou citizens, including three conditions: Hangzhou domiciliary register; resided in for more than one year; more than 16 years old. with a final sample size of about 600 individuals.(2) Sampling method: Samples were obtained under multi-stage sampling procedure. The primary stage was to select two districts randomly in Hangzhou. During the second stage, four "Jiedao" (a sub-district neighbourhood administration) were selected, two "Jiedao" for each selected district. During the third stage, two communities were selected randomly from each "Jiedao". Thus, 8 communities were obtained in total. Finally, 30 households were selected from each community as ultimate sampling units using a systematic random procedure. All residents according to the conditions were selected for this study.(3) To correct data by self-administered questionnaire. This survey wasconducted using self-designed questionnaire, which involved contents as follows: sociodemographic variables, health status, health behavior, and belief, emotional belief, attitude towards behavior, subjective norm, resources, health seeking behavior and intention.(4) Analysis: All data were entried using EpiDATA3.0, and statistical analysis were carried out using the SPSS 12.0 and Answer tree program. The Cronbach's alpha coefficients and factor analysis were used to test the reliability and validity; Descriptive statistics were used to present demographic data, health behavior and attitude, the main characteristics of medical consumption behavior; Contingency table, Chi-square test, Correspondence analysis, Multinomial Logistic regression analysis and Chi-squared Automatic Interaction Detector(CHAID) were used to analysis the influence factors of medical consumption behavior.Main results720 individuals were invited to this survey, and 632 questionnaires were taken back, with a response rate of 87.8%. And 602 respondents were valid (95.3%).1. Tests of reliability and validity: The Cronbach's alpha coefficients and split-half reliability were calculated to be 0.919 and 0.941 respectively for the health belief questionnaire, Factor analysis identified only one principal components that explain 68.91% of the variance. The Cronbach's alpha coefficients and split-half reliability were calculated to be 0.772 and 0.813 respectively for the emotional belief questionnaire, Factor analysis identified two principal components that explain 40.97% and 14.50% of the variance respectively.2. The main characteristics of medical consumption behavior: the diseases involved in this survey mainly were respiratory and gastrointestinal disease. In the last year, 20% of respondents had never suffered those diseases; 56% and 24% of respondents had suffered 1~2 times and 3 times diseases. No significant differences in the times of illness could be found for the cases regarding age and sex. Among the respondents, the proportion of choosing to see a doctor, self-medicine, and forbear were 24.6%, 54.9% and 20.4%. Feeling not so bad was the most important reason for...