黑龙江省居民门诊就诊流向及影响因素分析  

Outpatient flow of residents in Heilongjiang Province and the influence factors

作　　者：邵瑛琦 吴群红[1] 单凌寒[1] 李晨希 王星 孟祥伟 李乐 SHAO Yingqi;WU Qunhong;SHAN Linghan;LI Chenxi;WANG Xing;MENG Xiangwei;LI Le(School of Health Management,Harbin Medical University,Harbin,Heilongjiang 150081,China)

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081

出　　处：《中国农村卫生事业管理》2021年第6期387-391,405,共6页Chinese Rural Health Service Administration

基　　金：国家自然科学基金重点资助项目(71333003);黑龙江省高等学校新型智库建设支持计划研究项目(ZKWT1013)。

摘　　要：目的分析黑龙江省居民门诊就诊流向现状及其影响因素。方法使用第五次国家卫生服务调查黑龙江地区数据,利用描述性分析、卡方检验和Logistic分析等方法描述门诊就诊流向现状并分析影响因素。结果黑龙江省居民较倾向于利用基层医疗机构门诊服务,其门诊率为79.6%。但基层首诊率尚未达到100%,研究发现影响其门诊就诊流向的因素为农村地区(OR=2.638,P=0.009)、最近医疗机构距离<1公里的居民(OR=1.822,P=0.004)与文化程度较低的居民(OR:1.633~2.552,P:0.004~0.036)倾向于去基层卫生机构就诊;而青壮年居民(OR=0.544,P=0.004)、离退休居民(OR=0.478,P=0.037)更倾向于利用非基层卫生机构门诊服务。结论黑龙江省居民的基层医疗机构就诊率高于全国平均水平,居民门诊首选受到区域医疗资源分布与配置状况、患者自身医疗素养与人口结构等因素影响。基层卫生机构应合理分布,努力提升自身诊疗水平、加大基层宣传力度以满足患者需求并提高自身认可度。Objective To analyze the status quo of outpatient flow in Heilongjiang Province and the influence factors. Methods Data of Heilongjiang Province were collected from the database of The Fifth National Health Service Survey and analyzed by descriptive analysis, Chi-square test and binary logistic regression. Results Residents in Heilongjiang Province were more inclined to use the outpatient services of primary medical institutions, with an outpatient rate of 79.6%. However, the first consultation rate at the grassroots level had not yet reached 100%. The study found that rural residents(OR=2.638, P=0.009), residents living less than 1 km away from the nearest medical institutions(OR=1.822, P=0.004), and residents with lower education level(OR=1.633-2.552, P=0.004-0.036) were more inclined to visit primary health institutions. Young adults(OR=0.544, P=0.004) and retired residents(OR=0.478, P=0.037) were more likely to visit non-primary health institutions for outpatient services. Conclusions The rate of visits to primary health institutions in Heilongjiang Province is higher than the national average. The distribution and allocation of regional health resources, patients’ medical literacy, and population structure are the factors that affect the residents’ choice of outpatient clinics. Thus, the primary health institutions should be rationally distributed, improve their own level of diagnosis and treatment, increase grass-roots publicity to meet patients’ needs, and improve their own recognition.

关 键 词：分级诊疗 门诊患者 就诊费用 就诊流向 影响因素 黑龙江省 基层医疗机构 

分 类 号：R197.1[医药卫生—卫生事业管理] R19[医药卫生—公共卫生与预防医学]