@文章{信息:doi/10.2196/18481，作者=“马倩倩和孙洁，东旭和崔东旭，方芳和翟芳，赵云凯和赵洁，何洁和何，仙英和石，金明和高，景红和李，明远和张文杰”，标题=“互联网对中国成年人医疗决策的影响:纵向数据分析”，期刊=“J Med Internet Res”，年=“2020”，月=“9”，日=“3”，卷=“22”，号=“9”，页=“e18481”，关键词=“互联网;医疗决策;卫生保健提供者的选择;成年人;纵向数据分析;背景:互联网导致了医学信息的爆炸式增长，极大地提高了医学知识的可获得性。这使得互联网成为居民就医前获取医疗信息和知识的主要途径之一。然而，关于互联网如何影响医疗决策的研究很少。目的:本研究的目的是探讨中国18岁及以上成年人的网络行为与医疗决策的关系，包括是否去医院和选择哪个级别的医疗机构。方法:以城乡12个地区的成年居民(≥18岁)为研究对象，分析不同特征成年人在医疗选择上的差异，采用广义线性混合模型对2006 - 2015年中国健康营养调查的纵向数据进行分析。 Results: Adult groups with different ages, genders, education levels, regions, places of residence, severities of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse medical decisions, and the differences were statistically significant (P<.05). After controlling for these potential confounding factors and taking self-care as the reference, the probability of Chinese adults who participated in online browsing activities selecting hospital care was 0.82 (95{\%} CI 0.69-0.98; P=.03) times that of residents who did not participate in online browsing activities. In terms of medical institution choices, adults who participated in online browsing activities were 1.86 (95{\%} CI 1.35-2.58; P<.001) times more likely to opt for municipal medical treatment than primary care. However, the effect of online browsing on the selection probability of county-level hospitals was not significant compared with primary hospitals (P=.59). Robust analysis verified that accessing the internet had a similar effect on Chinese adults' medical decisions. Conclusions: Chinese adults who use the internet are a little less likely to go to the hospital than self-care. The internet has broken down the barriers to obtain knowledge of common diseases and thus has a slight substitution effect of self-care on hospital care. Internet use may increase the probability of adults going to municipal hospitals. The rising tendency of visiting high-level medical institutions may be consequently exacerbated due to knowledge monopoly of severe and complicated diseases that is difficult to eliminate, and the increase in inconsistent and incomplete medical information online will blur the residents' cognitive boundary of common diseases and severe diseases. Exploring the substantive impact of the internet on medical decision making is of great significance for further rational planning and utilization of the internet, in order to guide patients to appropriate medical institution. ", issn="1438-8871", doi="10.2196/18481", url="//www.mybigtv.com/2020/9/e18481", url="https://doi.org/10.2196/18481", url="http://www.ncbi.nlm.nih.gov/pubmed/32880581" }