多元主体治理视角下患者就医获得感影响因素研究  

Study on the Influencing Factors of Patients’Sense of Gain of the Medical Treatment from the Perspective of Multiple Subjects

作　　者：杨雯 王小合[1] 王福洁 郑国管 卫燕青 汪慧[1,3] 钱宇[1,4] 任佳焌[1,5] 陈洁 YANG Wen;WANG Xiao-he;WANG Fu-jie(Department of Health Service Management,College of Medicine,Hangzhou Normal University,Hangzhou,Zhejiang,311121,China)

机构地区：[1]杭州师范大学医学院卫生事业管理系,浙江杭州311121 [2]浙江大学医学院附属口腔医院,浙江杭州310006 [3]安徽医科大学第一附属医院,安徽合肥230022 [4]杭州市第一人民医院,浙江杭州310006 [5]浙江大学医学院附属第二医院,浙江杭州310006 [6]浙江大学医学院附属第一医院,浙江杭州310000

出　　处：《中国医院管理》2021年第1期36-39,共4页Chinese Hospital Management

基　　金：国家自然科学基金面上项目(71673075,71974050)。

摘　　要：目的分析政府、公立医院、社会多元主体对患者就医获得感的治理作用及影响,为增强患者就医获得感乃至进一步协同提升患者满意度提供借鉴及思考。方法采用定额抽样的方法对浙江省15家城市和县级公立医院的住院患者进行问卷调查,通过多重线性回归分析患者就医获得感的治理影响因素。结果政府对医疗服务公平性问题改善情况、居住地医疗机构整体规划和布局合理性、分级诊疗政策引导效果等因素影响患者就医获得感(P<0.05),医院公平公正处理医疗纠纷、对基层医疗卫生机构转诊提供便利以及为患者提供便利畅通的投诉渠道影响患者就医获得感(P<0.05),社会公众积极主动向政府反映医患双方意见及诉求、社会专业组织发挥医疗行业行为自律和内部监督职责、患者对当前医生群体所处社会医疗环境看法等因素影响其就医获得感(P<0.05)。结论可以通过推动政府切实履行职责、提升医院管理水平和调动社会公众参与治理积极性以协同增强患者就医获得感。Objective To analyze the effect of multiple subjects on patients’access to medical treatment,and to provide reference and thinking for enhancing patients’sense of gain medical treatment and even further improving patients’satisfaction.Methods By using the method of quota sampling,the inpatients of 15 cities and county public hospitals in Zhejiang Province were surveyed,and the factors influencing the patients’access to medical treatment were analyzed by multiple linear regression.Results The government’s improvement of the fairness of medical services,the rationality of the overall planning and layout of medical institutions where patients live,and the guiding effect of graded diagnosis and treatment all affect the sense of patients’access to medical care(P<0.05).Hospitals’fair and impartial handling of medical disputes,convenient referral with primary medical and health institutions,and unblocked complaint channels affect patients’sense of medical access(P<0.05).The public actively report to the government the opinions and demands of both doctors and patients,social professional organizations give play to the self-discipline and internal supervision of the medical industry,and patients’views on the current social medical environment of doctors affect their sense of medical access(P<0.05).Conclusion It can enhance the patients’sense of gain by promoting the government to perform its duties effectively,raising the level of hospital management,and mobilizing the public to participate in governance.

关 键 词：多元主体 治理 患者 就医获得感 影响因素 

分 类 号：R197.32[医药卫生—卫生事业管理]