赣州市章贡区居民对分级诊疗制度的认知、满意度及影响因素分析  

Residents’ cognition,satisfaction of classified diagnosis and treatment policies and its infuencing factors in Zhanggong District of Ganzhou City

作　　者：陈海燕[1] 张娟[1] 欧阳璐[1] 梅思思 CHEN Hai-yan;ZHANG Juan;OUYANG Lu;MEI Si-si(Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院预防医学系

出　　处：《赣南医学院学报》2019年第7期700-705,共6页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市社会科学研究课题(编号:17366)

摘　　要：目的:了解章贡区居民对分级诊疗政策的认知及满意度情况,并探讨其影响因素,为了解分级诊疗制度的实施情况及存在问题提供依据。方法:随机选取章贡区16岁以上居民为调查对象,采用自制调查表收集相关资料,主要包括居民基本信息(如性别、年龄、月收入、学历、职业和医疗费用的负担方式)、其对分级诊疗和基层医疗机构的认知情况、态度及对基层医疗机构的期望等,采用描述性流行病学方法对居民的认知、态度情况进行分析,并采用单因素logistic回归方法分析分级诊疗知晓率的影响因素。结果:发放问卷400份,回收386份,回收率为96.50%。在386份有效问卷中,有130人知晓分级诊疗的相关知识,知晓率为33.68%,其知晓途径主要是医疗机构的宣传(占56.15%),其次是书刊、报纸、媒体(占26.92%),及家人、朋友(占16.92%);29.00%(112/386)的居民所在的社区进行过分级诊疗的宣传;82.12%(317/386)的居民有过在基层医疗机构就医的经历,其中82.65%(262/317)居民对上一次基层医疗机构的就诊经历表示满意;患小病时选择到社区医院就诊的人数最多,占43.30%,其次为大医院和私人诊所,分别占43.30%和23.30%;22.02%的居民有转诊经历,其中分别有61.18%(52/85)和68.24%(58/85)的居民对接诊部门接诊的及时性和诊疗效果表示满意,74.12%(63/85)居民认为双向转诊比较便捷;居民的学历、职业、医疗费用负担方式、社区是否宣传分级诊疗政策、居民是否有转诊经历和居民患小病时的就医方式与分级诊疗政策的知晓率有关(P<0.05);月收入和医保类型为分级诊疗满意度的影响因素(P<0.05)。结论:居民对分级诊疗政策的知晓率较低,且社区相关政策的宣传及转诊服务水平有待进一步加强,其对基层医疗机构的满意度较高。加强对分级诊疗政策的宣传、优化基层医疗机构的资源配置将有助于促进分级诊疗政策的实施。Objective:To investgate the cognition and satisfaction situation of the residents on in Zhanggong district and discuss the influencing factors,and to provide basis for understanding the implementation and existing problems of the system.Methods:Using the method of encountering,the residents whose age were over 16 years old were randomly selected as the objects.Then the self-designed questionnaire were using to collect related information,including basic information (such as gender,age,income,education,occupation and the way of the burden of health costs),their cognitive situation of grading policy,knowning way,attitudes,and expectations Basic medical institutions.Residents' cognition situation was analyzed by adopting the method of descriptive epidemiology,and the method of single factor logistic regression analysis was adopted to explore the influence factors of awareness rate of grading policy.Results:A total of 400 questionnaires were distributed,in which 386 cases were recovered,the recovery rate was 96.50%.During the 386 valid questionnaires,130 people were aware of the knowledge related to grading policy,and the awareness rate was 33.68%.The awareness was mainly due to the promotion of medical institutions (56.15%),followed by books,newspapers,and media (26.92%),family members and friends (16.92%);29.00%(112/386) community ever conducted the propagation on grading policy;82.12%(317/386) residents had the experience of visiting basic medical institutions,of whom 82.65%(262/317) were satisfied with the last experience of the visiting.The people who chose to attend a community hospital during a minor illness were the most,accounting for 43.30%,followed by the large hospitals and private individuals,which accounted for 43.30% and 23.30% respectively;22.02% of the residents had referral experience,of which 61.18%(52/85) residents were satisfied with the timeliness of the admissions department,and 68.24%(58/85) residents were satisfied with the results of the consultation department's diagnosis,but 25.88%(22/85)

关 键 词：分级诊疗 知晓 满意度 基层 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]