疫情防控常态化模式下新疆南疆城乡居民就医机构选择及影响因素研究  

Study on the Selection and Influencing Factors of Medical Institutions for Urban and Rural Residents in Southern Xinjiang under the Normalization Mode of Epidemic Prevention and Control

作　　者：麦尔哈巴·如则 王飞[2] 祖丽皮耶·麦麦提祖农 魏晶晶[1] MAIERHABA·Rouze;WANG Fei;ZULIPIYE·Maimaitizunong;WEI Jingjing(School of Public Health,Xinjiang Medical University,Urumqi,830011,China;不详)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆维吾尔自治区人民医院医务部,新疆乌鲁木齐830011

出　　处：《中国社会医学杂志》2023年第1期31-35,共5页Chinese Journal of Social Medicine

基　　金：新疆法学会重点项目(XF2020A02);新疆维吾尔自治区卫生与健康适宜技术推广项目(SYTG-201994);新疆维吾尔自治区创新环境(人才、基地)建设专项项目(2019Q059)。

摘　　要：目的 在疫情防控常态化模式下,了解新疆南疆城乡居民就医机构选择情况,改善城乡居民就医机构选择行为。方法 在2021年1-3月期间,采用多阶段随机抽样的方法,在南疆四地州中随机抽取4个县,每个县抽取一个社区和一个乡镇,共800例18岁及以上居民作为调查对象,采用自行设置的问卷,调查居民基本情况、对就医机构的满意度、就诊医疗机构就医选择等,对就诊医疗机构选择进行单因素卡方检验和多因素非条件Logistic回归分析。结果 就医首选基层医疗机构者占33.9%,首选综合医院者占66.1%。多因素二分类非条件Logistic得出,农村户口居民、家庭月收入<1 000元者更倾向于选择基层就诊(P<0.05),对就诊环境不满意(OR=2.776,95%CI:1.08~7.106)、一般(OR=2.501,95%CI:1.657~3.775)、比较满意(OR=2.532,95%CI:1.619~3.960)的城乡居民多选择就诊环境好的医疗机构就诊(P<0.05)。结论 城乡居民就医机构选择存在不合理选择行为,对医疗机构的满意度持“一般”态度,基层医疗机构医疗技术水平较低;需要优化卫生资源、改善基层医疗机构基础建设、提升服务能力、加强疫情防控宣传、充分利用家庭医生签约服务团队,引导居民合理选择就医。Objective Under the normalization mode of epidemic prevention and control, to understand the selection of medical institutions for urban and rural residents in Southern Xinjiang, and to improve the selection behavior of medical institutions for urban and rural residents.Methods During the period from January to March 2021,four counties were randomly selected from the four prefectures of Southern Xinjiang by multi-stage random sampling method.Each county selected a community and a township as the object, and used A self-set questionnaire were used to investigate the basic situation, satisfaction with medical institutions, medical choice of medical institutions, etc.The selection of medical institutions was analyzed by univariate chi-square test and multivariate unconditional logistic regression.Results Primary medical institutions were the first choice for medical treatment, accounting for 33.9%,and general hospitals accounted for 66.1%.According to the results of logistic analysis of multi-factor two classification, rural residents or those with a monthly family income of <1 000 were more likely to choose grass-roots medical institutions(P<0.05).Those who were unsatisfied(OR=2.776,95%CI:1.08-7.106),generally satisfied(OR=2.501,95%CI:1.657-3.775),or relatively satisfied(OR=2.532,95%CI:1.619-3.960)with the medical environment chose to visit institutions with better environment.Conclusion Urban and rural residents have unreasonable choice behavior in the choice of medical institutions, hold a "general" attitude towards the satisfaction of medical institutions, and the medical technology level of grass-roots medical institutions is low.We need to optimize health resources, improve the infrastructure of grass-roots medical institutions, improve service capacity, strengthen epidemic prevention and control publicity, make full use of the contracted service team of family doctors, and guide residents to choose reasonable medical treatment.

关 键 词：就医行为 满意度 分级诊疗 疫情防控 影响因素 

分 类 号：R197.3[医药卫生—卫生事业管理]