某三甲医院医患双方分级诊疗认知度分析  

Cognition analysis of graded diagnosis and treatment between doctors and patients in a tertiary hospital

作　　者：崔倩倩 刘雪薇 张榆 葛爱民 李嘉诚 孔杨 Cui Qianqian;Liu Xuewei;Zhang Yu;Ge Aimin;Li Jiacheng;Kong Yang(School of Public Health and Management, Binzhou Medical University, Yantai 264003, China;Weifang Bureau of Statistics, Weifang 261000, China)

机构地区：[1]滨州医学院公共卫生与管理学院,山东烟台264003 [2]潍坊市统计局社会经济调查队,山东潍坊261000

出　　处：《中国医院统计》2021年第1期69-72,77,共5页Chinese Journal of Hospital Statistics

基　　金：教育部人文社会科学研究青年基金项目(19YJCZH072);山东省社会科学规划研究项目(18CKPJ20,19CDNJ01);国家级大学生创新创业训练计划项目(201910440025,S202010440023)。

摘　　要：目的了解医患双方对分级诊疗的认知情况,探讨影响患者就医意愿及医患双方对分级诊疗认知度的因素。方法采用偶遇法进行方便抽样,对滨州市某三甲医院的183名患者和92名医务人员,分别采用问卷和无结构式访谈的形式展开调查,根据logistic回归,分析影响医患双方对分级诊疗认知的因素。结果被调查对象中,38.2%的患者表示了解分级诊疗制度,44.1%的患者患病时选择基层医院首诊,学历越高的患者对分级诊疗的认知度越高(P<0.001),且了解分级诊疗制度的患者更倾向于选择基层医院首诊;70.6%的医务人员表示了解分级诊疗制度,但不同岗位的医务人员对分级诊疗的认知存在差异,临床医生对分级诊疗的认知度更高(P<0.001)。结论医患双方对分级诊疗的认知度均有待提高,患者选择基层首诊意愿也偏低。应对医患双方加强分级诊疗宣传力度,提高医患双方认知度,同时加大对基层医疗机构的投入,积极改善基层诊疗环境,全面提高基层服务能力,吸引患者选择基层首诊。Objective To understand the cognition of doctors and patients on graded healthcare,and to explore the factors affecting the patient's willingness to seek medical treatment and the awareness of the doctors and patients on the classification and treatment.Methods The accidental sampling method was adopted.One hundred and eighty-three patients and 92 medical staff of a tertiary hospital in Binzhou were investigated with questionnaires and unstructured interviews.According to logistic regression,the factors affecting the cognition of both doctors and patients on graded healthcare were analyzed.Results Among the surveyed subjects,38.2%of the patients said they understood the hierarchical diagnosis and treatment system,and 44.1%of the patients chose the primary hospital for the first consultation when they were sick.The higher the educational background,the higher the awareness of graded diagnosis and treatment(P<0.001).And patients who understand the hierarchical diagnosis and treatment system are more inclined to choose primary hospitals for the first diagnosis.70.6%of medical staff said they understood the hierarchical diagnosis and treatment system,but medical staff in different positions have different perceptions of hierarchical diagnosis and treatment,and clinicians have higher awareness of hierarchical diagnosis and treatment(P<0.001).ConclusionThe awareness of both doctors and patients on hierarchical diagnosis and treatment needs to be improved,and the willingness of patients to choose primary care at the grassroots level is also low.Both doctors and patients should strengthen the promotion of graded diagnosis and treatment,increase the awareness of both doctors and patients,and increase investment in primary medical institutions,actively improve the primary diagnosis and treatment environment,comprehensively improve primary service capabilities,and attract patients to choose primary diagnosis.

关 键 词：分级诊疗 认知度 医患双方 三甲医院 

分 类 号：R197.3[医药卫生—卫生事业管理]