吉林省县级公立医院患者分级诊疗认知状况调查  

Investigation on Cognition of Hierarchical Diagnosis System Among Patients of County Level Public Hospitals in Jilin Province

作　　者：于洗河[1] 万龙涛 顾文涛[1] 杨晔丽 李涛[1] 吴宁[1] Yu Xihe;Wan Longtao;Gu Wentao;Yang Lihua;Li Tao(School of Public Health,Jilin University,Changchun130021)

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》2017年第12期11-14,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患者对分级诊疗制度及其影响因素的认知,了解患者的就医意愿,分析分级诊疗制度实施过程中存在的问题,为相关政策的制定和完善提供依据。方法:采用方便抽样法对吉林省789名在县级公立医院就诊的患者进行问卷调查。采用描述性分析、单因素分析和Logistic回归分析探讨患者对分级诊疗制度的认知情况及其影响因素,了解患者的就医意愿。结果:只有28.4%的患者听说过分级诊疗,首诊在基层的患者比例为7.4%;不同文化程度、职业类型、双向转诊知晓情况、基层就医经历、双向转诊经历的患者,对分级诊疗的认知不同,差异有统计学意义(均P<0.05);Logistic回归分析结果显示,文化程度、基层就医经历和双向转诊知晓情况是影响分级诊疗认知的主要因素。结论:患者对分级诊疗制度相关政策的知晓率低、基层首诊意愿低、双向转诊相关政策知晓途径单一。建议加大对分级诊疗制度的宣传力度,引导患者建立科学的就医理念;提高基层医疗机构服务能力,打造健康有序的就医格局。Objective:To investigate cognition and influence factors of hierarchical diagnosis system among county level public hospital patients in Jilin province,understand their willingness of seeking diagnosis service,discuss the problem of hierarchical diagnosis system and provide planning data for formulating and improving the relevant policies.Methods:The convenient sampling method was used to investigate789patients of county level public hospitals in Jilin Province by questionnaire survey.The descriptive analysis,single factor analysis and multi factor regression model were used to explore cognition and influence factors of hierarchical diagnosis system among county level public hospital patients,to investigate their willingness of seeking diagnosis service.Results:The result showed that only28.4%of the patients were aware of the hierarchical diagnosis system.The proportion of first option at the grass-roots level hospitals was for7.4%.There was statistical significance of hierarchical diagnosis in education background,occupation type,grass-roots experience,two-way referral awareness,two-way referral experience of the patients(P<0.05).The results of logistic regression analysis showed that education background,grass-roots experience,two-way referral awareness were the major factors affecting patients cognition of hierarchical diagnosis system.Conclusion:The patients had a low awareness rate of the hierarchical diagnosis system,the first option at the grass-roots level was low,and the ways of knowing relative policies of two-way referral was relatively single.It was suggested to step up the publicity,guide the patients to establish a scientific treatment concept and to enhance the service capacity of grassroots medical institutions,and create a healthy and orderly medical treatment pattern.

关 键 词：分级诊疗 县级医院 患者 认知 吉林 

分 类 号：R197.323[医药卫生—卫生事业管理]