北京某医联体医患双方对分级诊疗模式认知的调查研究  

Investigation on Cognition of Hierarchical Medical System for both Doctors and Patients in a Medical Partnership of Beijing

作　　者：程苏华[1] 杨照[1] 孙玮[1] 

机构地区：[1]北京大学第一医院

出　　处：《医院管理论坛》2017年第3期19-22,共4页Hospital Management Forum

摘　　要：目的调研医患双方对分级诊疗的认知现状,分析分级诊疗实施中存在的问题,探讨解决问题方案。方法自行设计调查问卷,在北京某医联体内的三级医院及基层医疗机构的医生中发放问卷425份,并向在三级医院就诊的患者(亲属)随机发放问卷431份,对其中有效问卷进行统计学分析。结果医生了解并且清楚分级诊疗意义者占78.80%,而患方不知道分级诊疗的人数比例高达54.48%;医生认为阻碍分级诊疗实施的主要因素是患者不信任基层医疗机构医务人员技术水平、缺乏完善的激励机制、基层医务人员技术水平低、社区诊疗机构的药品不能满足临床需要等;患者不愿去社区卫生服务机构就医的主要原因是基层医疗机构的服务内容、转诊、诊疗水平、药品配置无法满足需求。结论居民对分级诊疗的认知程度不高,需要加强宣传,通过家庭医生签约制度形成医生与居民的紧密联系;建机制、强基层、畅转诊是实现分级诊疗模式的基础;当前紧密型医疗联合体是实现医疗资源有效整合和下沉的重要载体。Objective To investigate the cognition status of the doctors and patients on the hierarchical medical system, analyze the existing problems in the implementation, and discuss the solution. Methods Questionnaire was designed by the research team. A total of 425 questionnaires were distributed among the doctors in the third grade hospitals and primary medical institutions in Beijing. The questionnaires were distributed to 431 patients who were treated in the tertiary hospitals or their relatives randomly. The results were statistically analyzed. Results The doctors who know the hierarchical medical system and understand its meaning accounted for 78.80%, while the patients who do not know the hierarchical medical system accounted for 54.48%; The doctors believe that the main unfavorable factors of hierarchical medical system are the discredit of staffs＇ skills in primary medical institutions, the lack of the incentive mechanism, the low skill level of grassroots medical staffs and the satisfaction of medicine in the communities for clinical use. The reason of patients not willing to community medical care is the lack of primary health care services, qualifying referral, medical level and the necessary drugs. Conclusion The level of cognition for the residents is not high enough, which means that it is necessary to enhance publicity and form close relationship between doctors and the residents on the health management through the Family Doctor Signing System. Building mechanism, strengthening base, and smoothing referral are the foundational ideas for achieving the hierarchical medical model. Closer medical partnership plays an important role to achieve effective integration and implement of medical resources.

关 键 词：分级诊疗 认知 研究 

分 类 号：R24[医药卫生—中医临床基础]