基于北京市农村居民视角的城乡医患信任现状研究  

Study of Doctor- patient Trust in the View of Villagers in Beijing

作　　者：周新歌 王晓燕[1] 申昆玲[1] 董屹[1] 马晓[1] 周慧姊[1] 

机构地区：[1]首都医科大学卫生管理与教育学院,北京100069

出　　处：《医学与社会》2015年第7期64-66,共3页Medicine and Society

基　　金：北京市哲学社会科学规划重点项目;编号为14ZHA003;首都卫生管理与政策研究基地重大项目;编号为2013JD01;北京市属高等学校教学创新人才--教学名师项目;编号为PHR201106207

摘　　要：目的:了解农村居民对城乡各级医疗机构信任现状及其影响因素,提出增强医患信任的对策和建议。方法:在北京市怀柔郊区3个乡镇中选取12个行政村,进行为期18天的实地观察,并对24位村民进行定性访谈,分析村民对各级医疗机构的信任情况及其影响因素。结果:村民对城市大医院医生和村卫生室的总体信任评价平均分均优于乡镇卫生院,其主要原因为村卫生室"人际信任"牢固,城市大医院设备完善与医疗技术水平高等,而乡镇卫生院医药报销比例高,但诊疗水平、设备条件相对不足。村民与城市大医院和乡镇卫生院医生信任建立类型为声誉型,通过一般的就诊过程建立;与村医的信任类型为社会背景相似型,因为彼此熟悉。结论:提高村民对各级医疗机构的信任,需要不断强化农村医患"关系信任",提高村医技术水平;提高乡镇卫生院医保报销比例,完善药品目录;积极推进医联体建设,分流城市大医院就诊压力,促使患者有序就医。Objective： Described the trust of medical institutions and influencing factors, then making relevant suggestions. Methods： There is an observation period of 18 days for 12 administrative villages in Huairou Suburb of Beijing with 24 villagers needing qualitative interviews, described and analyzed the villagers of medical institutions at all levels status of trust and its influencing factors. Results： The average evaluation score about the villagers trust in large urban hospitals and village clinics doctors both are superior to township health centers. It mainly due to the strong ＂interpersonal trust＂ of village clinics, the complete equipment and advanced medical technology of big city hospital , and the high proportion of medical expenses, but lower diagnosis and treatment level and poorer equipment condition of township health centers. The type of patients trust in towns and townships, township hospitals are reputation - based trust, which built by general treatment process ; and to village doctor is the similar social background, because they are familiar with each other. Conclusion： In order to increase the villagers trust in medical institutions at all levels, it needs to constantly strengthen ＂trusted relationship＂ between the villagers and Village doctor, and improve the level of village doctor technology; Increase health care reimbursement ratio in towns and townships, perfect the catalogue of drugs; promote the construction of medical treatment combination actively for shunting big city hospital patients, and keep patients see a doctor orderly.

关 键 词：医患关系 医患信任 药品零差率 双向转诊 

分 类 号：R197.323.4[医药卫生—卫生事业管理]