湖北省麻城市农村患者就医机构选择偏好分析  

Analysis of preference on selecting medical institutions of rural patients in Macheng,Hubei Province

作　　者：段磊[1] 牛亚冬 徐源[1] 张研[1] 

机构地区：[1]华中科技大学医药卫生管理学院/湖北省人文社科重点研究基地农村健康服务研究中心,湖北武汉430030

出　　处：《中国卫生资源》2017年第3期255-258,262,共5页Chinese Health Resources

基　　金：国家青年自然科学基金"基于前景理论的县级医生连续性服务提供与激励研究"(71603088);博士后面上项目"中西部县区农村居民就诊选择的决策机制研究"(2015M582231)

摘　　要：目的:明确农村患者医疗服务机构级别选择偏好,为引导患者就医流向与规范就医选择提供依据与建议。方法:运用Excel 2013对麻城市2012—2014年新农合患者门诊及住院数据进行处理和分析,并运用SPSS 22.0对不同类型人群就诊机构选择差异进行卡方检验。结果:农村患者对于门诊服务偏好选择村级医疗机构,但占比由2012年的67.17%降到了2014年的37.35%;住院服务患者偏向选择县级医疗机构,50.10%的患者住院直接选择县级医疗机构。65岁及以上患者门诊选择村级医疗机构比例达到63.45%;乡镇卫生院服务能力低的地区,仅22.78%的具有选择偏好的门诊患者选择乡级医疗机构。结论:农村患者在门诊选择时更倾向于村级医疗机构,但选择村级机构的偏好逐年下降,而住院机构选择更倾向于县级医疗机构,患者在较高级别医疗机构就诊偏好逐年升高,老年患者更倾向于利用基层医疗机构服务,乡镇卫生院服务能力对门诊患者的选择影响较大。患者就医机构选择存在不合理性,呈现趋高态势。Objective： To make clear rural patients＇ preference on medical institution levels, and to provide suggestions for guiding patients＇ choice of medical institutions. Methods： Data of inpatients and outpatients under the New Rural Cooperative Medical System from 2012 to 2014 in Macheng were processed and analyzed by Excel 2013. Chi square test was used to compare the difference in selecting medical institutions among patients grouped by different characteristics using SPSS 22.0. Results： The proportion of rural outpatients who preferred village-level medical institutions decreased from 67.17% in 2012 to 37.35% in 2014, whereas 50.10% of rural inpatients preferred county-level institutions. A proportion of 63.45% of the patients aged 65 years and above selected village-level medical institutions for outpatient visits. The proportion of outpatients who selected township institutions in the area of poor township hospitals＇ service ability was measured as 22.78%. Conclusion： The selected outpatients in rural area prefer village-level medical institutions, though it is with a decreasing trend, while the inpatients prefer county-level ones. Generally, rural patients are more likely to select higher-level facilities. Senile patients have preference for county-level medical institutions, and the township hospitals＇ service level has great impact on outpatients＇ selection. Irrational choices of medical institutions among the patients exist and show a rising tendency.

关 键 词：农村患者 门诊 住院 机构级别 选择偏好 

分 类 号：R197[医药卫生—卫生事业管理]