山东省农村居民就医意愿及其影响因素分析  

Survey of rural residents' wills to medical treatment and its influencing factors in shandong province

作　　者：窦伟洁[1] 赵芳[1] 谷景亮[1] 韩志琰[1] 宋奎勐[1] 温楠[1] 李静丽[1] 马霞[1] 甄天民[1] 

机构地区：[1]山东省医药卫生科技信息研究所(山东省卫生服务与管理创新软科学研究基地)山东省医学科学院,250062

出　　处：《中华全科医学》2015年第9期1484-1485,1530,共3页Chinese Journal of General Practice

基　　金：山东省软科学研究项目(2013RZC03002);山东省医药卫生科技发展计划项目(2013WA0355;2014WS0319);山东省医学科学院院级科技计划(2013-17)

摘　　要：目的通过对样本人群的就医行为进行调查,了解山东省农村居民就医意愿,并对相关因素进行分析,为合理配置卫生资源,优化居民就医行为提供客观科学的依据。方法采用分层随机抽样的方法调查山东省1260名农村居民,采用自行设计的调查问卷进行调查。问卷内容包括基本情况、就医意愿及其影响因素、居民对基层医疗卫生机构评价等。收回有效问卷1194份,问卷有效率为94.76%。数据的分析采用SPSS 21.0软件进行。结果随着疾病严重程度的增加,居民对医疗机构的选择呈现两个趋势,一是到诊所/村卫生室(所)/社区卫生服务站(点)和乡镇卫生院/社区卫生服务中心/街道医院就诊的呈现下降趋势;二是到县市区级医院和省级医院就诊的呈现上升趋势,省级医院上升趋势较县市区级医院缓慢。居民选择基层医疗机构的主要原因是离家近、常见病和收费便宜,而选择上级医院的主要原因是诊疗水平放心和地理可及性高。从居民就医选择的标准来看,医疗水平占首位,医疗价格次之。结论居民在就医机构的选择上较为理智,良好的地理可及性、放心的诊疗水平和合理的医疗价格是主要影响因素。但是居民对乡镇卫生院等基层医疗机构的就医意愿并不是很高,因此基层医疗卫生机构需要进一步加强建设,以保障农村居民医疗服务的有效性。Objective Through the investigation of people seeking medical advices, to understand rural residents＇ willing- ness and its influence factors in Shandong so as to provide scientific references for rational allocation of health resources and optimization of resident＇ s medical behavior. Methods A total of 1260 residents were selected by stratified random sampling to investigate with the self-designed questionnaires. The questionnaire included basic information, willingness of seeking medical service, residents＇ evaluation of primary health care institutions. We successfully collected 1194 question- naires and the research had an effective rate of 94. 76%. Results With increasing severity of disease, residents chose to medical institutions showed two trends. One was to the clinic/village clinic/community health service stations（points） and the township health center/community health service center/street hospital showed a downward trend. Two was to the mu- nicipal hospital and provincial hospital showed a rising trend. But provincial hospital rose slowly than the municipal hospi- tal. The main reasons for residents to choose primary health care institutions were closing to home, common disease and in- expensive. The main reasons of choosing the superior hospital were the good diagnosis and treatment level and geographic accessibility. Medical level and medical price were the main standard of residents to choose medical institu- tions. Conclusion Residents were more rational on the choice of medical institutions. Good geographical accessibility, high level of diagnosis and treatment and reasonable price were the main influence factors. The willingness of seeking medical service about primary health care institutions was not high. Primary health care institutions should further improved so as to guarantee the effective health service.

关 键 词：农村居民 就医意愿 影响因素 

分 类 号：R197.62[医药卫生—卫生事业管理] R195[医药卫生—公共卫生与预防医学]