分级诊疗制度下患者就医意向的影响因素研究  

Analysis on factors affecting the patients' medical intention under hierarchical diagnosis system

作　　者：朱小凤[1] 李道丕 刘中华 张莉[1] 张永恒[1] 赵玮琳 ZHU Xiaofeng LI Daopi LIU Zhonghua ZHANG Li ZHANG Yongheng ZHAO Weilin(Suining Central Hospital, No.127, Desheng West Road, Chuanshan District, Suining, 629000, Sichuan Province, PRC)

机构地区：[1]遂宁市中心医院 [2]遂宁市卫生与计划生育委员会

出　　处：《中国医院》2017年第1期34-37,共4页Chinese Hospitals

基　　金：四川省基层卫生事业发展研究中心项目(SWFZ15-Z-10);遂宁市中心医院科研课题(2015y18)

摘　　要：目的:了解患者对分级诊疗的认知情况,探讨影响其患常见多发病时就医意向的因素,为下一步有针对性地进行干预提供参考依据。方法:采用分层与方便抽样方法,对遂宁市各级(三级、二级及社区)医疗机构共1072名患者进行问卷调查,调查内容包括患者的基本情况、对分级诊疗的认知情况及患常见多发病时的就医意向等。结果:患者对分级诊疗的知晓率低,仅38.2%,赞成率为58.4%。患者的文化程度、收入水平、医保类型、就业状况、对分级诊疗的认知情况、就诊医疗机构的宣传及转诊情况、所在社区的宣传情况、社区就诊经历(P<0.05)均对患者患常见多发病时的就医意向有影响。结论:各级医疗机构及社区应加大向广大民众宣传分级诊疗的力度,使其真正理解分级诊疗的内涵和意义,以期改变其长期以来的自由就医习惯,促进分级诊疗更加顺利的实施。Objective： To know the patients awareness of hierarchical diagnosis system and analyze its influencing factors for medical intention, and to provide references for its improvement. Methods： 1072 cases of patients were selected combined by stratified sampling and convenience sampling from different levels of medical institutions in Suining and had a survey with self-made questionnaire, including the general data, knowledge of hierarchical diagnosis system and medical intention. Results： Only38.2% patients had the awareness of hierarchical diagnosis, and their approval rate is 58.4%. The result showed the education level, monthly income, medical insurance, the employment situation, the cognitive situation of hierarchical diagnosis, propaganda in medical situation or community, referral experience and the clinical experience in community are all affecting the medical attention. The difference is statistically significant（P〈0.05）. Conclusions： Medical institutions at all levels and community should further enhance the propaganda of hierarchical diagnosis to make people really understand the connotation of hierarchical diagnosis and treatment. By the way, people can change the medical habits, so that hierarchical diagnosis system can be implemented smoothly

关 键 词：患者就医意向 分级诊疗 就医影响 

分 类 号：R197[医药卫生—卫生事业管理]