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目的基于国家卫生服务调查数据,核算估计陕西省特定区域居民人均卫生支出。方法采用小区域Fay-Herriot模型,估计2013年陕西省32个样本县/区和陕北、关中、陕南3个地域以及城乡居民的年人均卫生支出和误差,并分析相关影响因素。结果陕西省城市和农村人均卫生支出估计值分别为625元、463元,陕北、关中、陕南人均卫生支出估计值分别为596元、520元和473元。影响居民人均卫生支出的主要因素是城乡地区(陕北、关中、陕南)差异。Fay-Herriot模型拟合的对数似然函数绝对值分别为37.18,66.19,10.88。结论小区域直接估计和拟合Fay-Herriot模型方法,可获得特定区域的人均卫生支出估计值。采用地区、城乡差异模型较为准确核算出陕西省居民人均卫生支出,可为区域卫生管理决策或其他同类研究提供参考。
Objective To estimate the per capita health expenditure of residents in certain regions of Shaanxi Province based on the national health service survey data. Methods A small-area Fay-Herriot model was used to estimate annual per capita health expenditures and errors of 32 sample counties / districts in Shaanxi Province and three districts of Shaanxi, Guanzhong and Southern Shaanxi and the related factors. Results The per capita health expenditure of urban and rural areas in Shaanxi Province was estimated to be 625 yuan and 463 yuan respectively. The estimated per capita health expenditures in northern Shaanxi, central Shaanxi and southern Shaanxi were 596 yuan, 520 yuan and 473 yuan respectively. The main factor that affects per capita health expenditure of residents is the difference between urban and rural areas (northern Shaanxi, central Shaanxi and southern Shaanxi). The absolute value of the log-likelihood function fitted to the Fay-Herriot model was 37.18, 66.19, and 10.88, respectively. Conclusion Small area direct estimation and Fay-Herriot model fitting method can get the estimated value of per capita health expenditure in a specific area. Using the regional and urban-rural difference models to calculate the per capita health expenditure per capita in Shaanxi Province, it can provide reference for regional health management decision-making and other similar studies.