شناسایی و ارزش گذاری عوامل موثر بر تصمیم شهروندان تهرانی جهت ورود به طرح پزشک خانواده؛ با استفاده از آزمایش انتخاب گسسته

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری اقتصاد دانشگاه تهران

2 استاد اقتصاد دانشگاه تهران

چکیده

با وجود موفقیت‏های نسبی نظام سلامت ایران و ارتقای بسیاری از شاخص‏های بهداشتی طی دو دهة گذشته، نظام سلامت ایران کماکان با مشکلات جدّی مواجه است. یکی از مشکلاتِ مهم‏ بی‏عدالتی در دسترسی به خدمات سلامت است. مطالعات نظری و شواهد عملی گویایِ آن است که اجرای نظام ارجاع و طرح پزشک‏ خانواده یکی از راهکارهای اصلیِ برطرف‌ساختن بی‏عدالتی‏ها در حوزة سلامت و استفادة مناسب از منابع کمیاب در این حوزه است. برای اجرای موفقیت‏ آمیز طرح پزشک خانواده، ضرورت دارد علاوه بر رفع برخی مشکلات شناخته‌شده و ایجاد بستر‏های لازم، با استفاده از روش‏های علمی، مؤلفه‏ های اثرگذار در تصمیم مشارکت‏ کنندگان در این طرح شناسایی شود و سیاست‌گذار حوزة سلامت، به‏ منظور افزایش احتمال توفیق اجرایی‌شدن آن، بستة سیاستی‏ای تدوین کند که با حداکثر انطباق با ترجیحات جامعة هدف تهیه شده باشد. در همین ‏زمینه، مطالعة حاضر به‏ منظور شناسایی ترجیحات شهروندان تهرانی، به ‏عنوان یکی از مشارکت‏کنندگان در طرح، انجام گرفته است. نتایج نشان‌دهندة آن است که مؤلفه‏های ویزیت، رفتار پزشک، نحوة وقت‏گذاری پزشک در معاینات، و دسترسی تلفنی آثار معنی‏داری در متمایل شهروندان برای ورود به طرح پزشک خانواده دارد؛ به طوری که افزایش ویزیت موجب کاهشِ تمایل افراد برای ورود به این طرح می‌شود. به علاوه، رفتار توأم با ‏احترام پزشک، وقت‏گذاری مناسب و نیز امکان دسترسی تلفنی به افزایشِ مطلوبیت شهروندان منجر می‌شود و احتمال مشارکت آن‌ها و ورودشان به طرح را افزایش می‏دهد. تمایل شهروندان به پرداخت برای هر یک از مؤلفه‏های رفتار پزشک، نحوة وقت‏گذاری و دسترسی تلفنی به‌ترتیب 579/9، 947/9 و 750/3 تومان برآورد شده است.

کلیدواژه‌ها

عنوان مقاله [English]

Identification and evaluation of the factors that influencing the decision of Tehran citizens to enter to family practice, using a discrete choice experiment

نویسندگان [English]

  • Seyyed Mohammad Hadi Sobhanian 1
  • Jafar Ebadi 2
  • Mohsen Mehrara 2
1 Ph.D in Economics, Tehran University
2 Professor of Economics, Tehran University
چکیده [English]

Despite the relative success of the health system and the promotion of health indicators over the last two decades, Iran's health system still faces serious problems. One of the most important of them, is the inequity in access to health. Theoretical studies and empirical evidences indicate that implementation of the referral system and family physician plan, is one of the main strategies to overcome inequity in the health and appropriate using of scarce resources in this area. In order to successful execution of the family physician, it is necessary, in addition to reform some known problems, the important factors influencing the decision of participants in the project have been identified by using scientific studies and methods and policy makers develop a package that is designed with maximum compliance to the preferences of the target population in order to increase the likelihood of successful implementation.This study is conducted for this purpose. The results indicate that,the visit,behavior of physician, the time of examination has been spent by doctor and being on call are attributes that influence the decision of citizens to enter to family physician. As we expected, increasing in visit, reduces the willingness to entrance to plan. The respectful behavior that given by the doctors, spending the appropriate time for patients and being On-call, increase the utility of citizens and the probability of their entrance to plan.The willingness to pay for behavior of physician,the time of examination and the attribute of On-call are estimated respectively 9579 , 9947 and 3750 Toman.

کلیدواژه‌ها [English]

  • family physician plan
  • Preferences
  • Discrete Choice Experiment

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  • تاریخ دریافت: 17 خرداد 1393
  • تاریخ بازنگری: 01 دی 1393
  • تاریخ پذیرش: 19 اسفند 1393

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