影响社区居民首诊医院选择的相关因素调查  

Analysis of the Influence of Residents’Willingness on Primary Treatment

作　　者：李哲[1] 刘莉[2] 房特[1] 陈凤收[1] 佟青 崔赛赛 马虹[1] LI Zhe;LIU Li;FANG Te;CHEN Fengshou;TONG Qing;CUI Saisai;MA Hong(Department of Anesthesiology,The First Hospital of China Medical University,Shenyang Liaoning 110001,China;Institute of Chronic Disease,Liaoning Provincial Center for Disease Control and Prevention,Shenyang Liaoning 110005,China;Department of Science and Technology,The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou Liaoning 121001,China;Health Management Center,The General Hospital of Northern Theater Command,Shenyang Liaoning 110015,China)

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110001 [2]辽宁省疾病预防控制中心慢性非传染性疾病预防所,辽宁沈阳110005 [3]锦州医科大学附属第三医院科技部,辽宁锦州121001 [4]中国人民解放军北部战区总医院健康管理中心,辽宁沈阳110015

出　　处：《中国医疗设备》2020年第5期25-28,共4页China Medical Devices

基　　金：国家重点研发计划(2017YFC0114207)。

摘　　要：目的了解社区居民对首诊医院的选择及其影响因素,为政府制定有效政策提供科学依据。方法随机选取沈阳市铁西区六个社区共1200名居民作为调查对象,调查主要包括社区居民的基本资料、首诊医院的选择、影响首诊医院选择因素。结果发放问卷1200份,收回有效问卷1161份,有效率为96.75%。在1161份有效问卷中,38.8%的居民首诊选择三级医院,24.1%的居民首诊选择社区卫生服务中心。选择在三级医院做CT、彩超、心电图的社区居民比例为72.4%、61.8%和50%,而选择在社区卫生服务中心做CT、彩超、心电图的社区居民比例只为5.3%、6.9%、10.6%。调查发现,34.5%的居民认为应该提高基层医院的报销比例,81.1%的居民认为利用云平台请上一级医院的医生对检查结果进行远程诊断,可以首选基层医院检查。结论医生诊疗水平、疾病严重程度、设备水平是影响社区居民选择社区医院作为首诊医院的首要三个因素。优化基层医疗机构的资源配置、制定相关医保政策、利用云平台可能会改变社区居民的首诊选择。Objective To investigate and analyze the community residents’willingness on primary treatment and its influencing factors,so as to provide scientific basis for the government to make policies.Methods A total of 1200 residents were randomly selected from six communities in Tiexi District of Shenyang.The questionnaire mainly included the baseline information of residents,the attitudes towards the primary treatment hospital and its in?uencing factors.Results A total of 1200 questionnaires were distributed,in which 1161 cases were recovered,the recovery rate was 96.75%.Among the 1,161 valid questionnaires,38.8%of residents chose tertiary hospitals and 24.1%chose community health centers as primary treatment.72.4%,61.8%and 50%of community residents chose tertiary hospitals for CT,color ultrasound and ECG,while only 5.3%,6.9%and 10.6%chose community health centers.There were 34.5%of residents believed that if the reimbursement ratio of medical insurance was increased,and 81.1%believed that if doctors from the superior hospitals were available for remote diagnosis on the cloud platform,community health centers could become the preferred examination object.Conclusion The clinical level of doctors,the severity of diseases and the quality of equipment are the three primary factors that affect the residents’willingness on primary treatment.Optimizing the allocation of resources of community health centers,formulating medical insurance policies,and using cloud platform may change the choice of community residents.

关 键 词：首诊医院 分级诊疗 社区卫生服务中心 医疗设备 

分 类 号：R197.6[医药卫生—卫生事业管理]