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张千千,任德宇,陈玉,等.农村居民对上消化道癌无痛内镜筛查的支付意愿分析*[J].中国卫生经济,2022,41(11):63-68.[点击复制] |
ZHANG Qian-qian,REN De-yu,CHEN Yu,et al.Analysis on the Willingness-to-pay for Painless Endoscopic Screening for Upper Digestive Tract Cancer among Rural Residents[J].CHINESE HEALTH ECONOMICS,2022,41(11):63-68.[点击复制] |
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| 农村居民对上消化道癌无痛内镜筛查的支付意愿分析* |
| 张千千,任德宇,陈玉,张欢,李一帆,魏文剑,王家林,张楠 |
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| (1.山东大学齐鲁医学院公共卫生学院 济南 250012 2.山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心 济南 250012 3.国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学) 济南 250012 4.山东第一医科大学(山东省医学科学院) 济南 250021 5.山东省肿瘤防治研究院(山东省肿瘤医院),山东第一医科大学(山东省医学科学院) 济南 250117) |
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| 摘要: |
| 目的：了解农村居民对无痛内镜筛查的支付意愿，为改进上消化道癌筛查策略和促进筛查可持续发展提供参考依据。方法：采用分层整群随机抽样，在山东省3个县(市、区)选取40~69岁既往未被诊断为癌症的农村居民为调查对象。 采用基于条件价值评估法的边界二分式和开放式相结合的方法，面对面调查受访者对无痛内镜筛查的支付意愿。用STATA 16.0进行支付意愿影响因素的Tobit回归分析。结果：最终纳入分析的959名研究对象中，有86.97%的农村居民愿意接受无痛内镜筛查，余下13.03%的农村居民不愿意接受的主要原因是“在感到身体不适后自行就诊”。当筛查需要个人自付部分费用时，有64.39%的农村居民愿意支付一定费用。假设筛查总费用为1000元，愿意支付500元以上的农村居民占30.70%，愿意支付700元以上的农村居民占14.51%，农村居民的平均支付意愿为310.70元，占总费用的31.00%。地区、性别和收入是居民支付意愿的显著影响因素，肥城市农村居民比临朐县居民愿意多支付118.85元/人；男性比女性多愿意支付63.09元/人；年收入每增加10000元，农村居民的筛查支付意愿就增加16.40元/人。结论：农村居民对无痛内镜筛查的接受度较高，但支付意愿及支付额度均较低。应提高农村居民对无痛内镜筛查的认知及自身健康的责任意识，同时建立筛查服务共付机制，将无痛内镜筛查自付比例控制在30%左右，提高筛查参与率。 |
| 关键词: 农村居民 上消化道肿瘤 无痛内镜筛查 支付意愿 |
| DOI： |
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| 基金项目:基金项目：国家自然科学基金项目(71904109) |
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| Analysis on the Willingness-to-pay for Painless Endoscopic Screening for Upper Digestive Tract Cancer among Rural Residents |
| ZHANG Qian-qian,REN De-yu,CHEN Yu,ZHANG huan,LI yi-fan,WEI wen-jian,WANG jia-lin,ZHANG nan |
| (School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 , China) |
| Abstract: |
| Objective: To investigate the willingness-to-pay for painless endoscopic screening among rural residents, to provide references for improving the screening strategy of upper gastrointestinal cancer and promoting screening sustainable development. Methods: Stratified cluster random sampling was used to select rural residents aged 40 ∼69 who had never been diagnosed with cancer in Shandong Province. Based on Contingent Valuation Method, a combination of double-bounded dichotomous choices and open-ended questions was used to investigate respondents' willingness-to-pay for painless endoscopic screening. The Chi-square test and Tobit regression for the influencing factors of respondents' willingness-to-pay were carried out with STATA 16.0 Software. Results: Of the 959 respondents, 86.97 %were willing to accept painless endoscopic screening, and 13.03 %stated unwillingness because they didn't attend clinics until symptom onset. 64.39 %of the residents were willing to pay part of the screening cost among those willing to accept screening. Assuming that the total screening cost was 1000 yuan, 30.70 %of the residents were willing to pay more than 500 yuan, 14.51 %were 700 yuan. The average willingness-to-pay was 310.70 yuan, accounting for 31.00 %of the total cost. Region, gender and income were the significant influencing factors of residents' willingness-to-pay. Residents in Feicheng were more willing to pay 118.85 yuan/person than residents in Linqu County, and male were more willing to pay 63.09 yuan/person than female. For every 10000 yuan increased in annual income, residents' willingness-to-pay would increase by 16.40 yuan/person. Conclusion: The acceptance for painless endoscopic screening among rural residents was considerable. The willingness-to-pay and payment amount were relatively low, indicating the necessity of improving residents' awareness on painless endoscopic screening and self-health responsibility, establishing screening co-payment mechanism, and controlling individuals' out-of-pocket at about 30.00 %. |
| Key words: rural resident upper digestive trace cancer painless endoscopic screening willingness-to-pay |
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