吉林省县级公立医院医生分级诊疗认知状况调查  

Investigation on Cognition of Hierarchical Diagnosis System Among County Level Public Hospital Doctors in Jilin Province

作　　者：于洗河[1] 万龙涛 杨晔丽 顾文涛[1] 贾欢欢 孙宇哲 Yu Xihe(School of Public Health,Jilin University,Changchun,130021)

机构地区：[1]吉林大学公共卫生学院,长春130021

出　　处：《医学与社会》2018年第6期24-27,共4页Medicine and Society

基　　金：吉林市卫生和计划生育委员会项目"基于效用理论探索新医改分级诊疗制度对居民就医行为的影响";编号为371161703427

摘　　要：目的:了解吉林省县级公立医院医生对分级诊疗制度的认知及影响因素,为相关政策的制定和完善提供依据。方法:采用分层抽样的方法对吉林省1541名医生进行问卷调查。采用描述性分析、非参数秩和检验和多因素回归模型探讨医生对分级诊疗制度的认知及影响因素。结果:县级公立医院医生对分级诊疗的知晓率为84.7%;28.7%的医生认为分级诊疗的实施效果好;单因素分析显示,年龄、工作年限、文化程度、医院类型与分级诊疗的知晓率有关联(均P<0.05);Logistic回归分析显示,医生对下级医疗机构诊断结果信任程度、分级诊疗知晓途径、培训情况、单位有无转诊指南、分级诊疗对医生经济收益影响情况是影响医生对分级诊疗认知的主要因素。结论:医生对分级诊疗制度知晓率较高但是实施效果有待提高,应进一步加大对分级诊疗制度的宣传,提高认知水平;加强各级医疗机构的信息沟通,建立统一的双向转诊制度和标准,从而促进分级诊疗制度的实施和完善。Objective： To investigate cognition and influence factors of hierarchical diagnosis system among county level public hospital doctors in Jilin Province and provide reference for formulating and improving the relevant policies. Methods： The Stratified Sampling were used to investigate 1541 doctors of county level public hospitals in Jilin Province by questionnaire survey. The descriptive analysis,nonparametric rank sum test and multinornial regression model were used to explore cognition and influence factors of hierarchical diagnosis system among the doctors. Results： 84.7% of county level public hospital doctors knew hierarchical diagnosis system and 28.7% of doctors believed that the implementation of hierarchical diagnosis system was effective. Single factors analysis showed that age,working years,education level and hospital type were related with their cognition（ P〈0.05）. The results of logistic regression analysis showed that doctors＇ confidence in the diagnosis of subordinate medical institutions,knowing ways of hierarchical diagnosis system,training,whether the hospital has a two-way referral guide,the impact of hierarchical diagnosis system on doctors＇ economic benefits were the major factors affecting doctors cognition of hierarchical diagnosis system. Conclusion： The doctors had a higher awareness of hierarchical diagnosis system but the effect of the implementation needed to be improved. We should further strengthen the publicity of hierarchical diagnosis system,improve cognitive level,strengthen the communication of medical institutions at all levels,establish a unified two-way referral system and standards,so as to promote the implementation and perfection of hierarchical diagnosis system.

关 键 词：医院管理 分级诊疗 吉林 

分 类 号：R197.32[医药卫生—卫生事业管理]