江苏省海安市基层医务人员对分级诊疗制度实施情况的满意度状况研究  

Study on the Status of Satisfaction of Grassroots Medical Staff on the Status of Implementation of the Hierarchical Medical System in Hai'an City of Jiangsu Province

作　　者：马海峰 应晓华[1] MA Haifeng(School of Public Health,Fudan University,Shanghai,200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032

出　　处：《医学与社会》2023年第7期7-12,共6页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为72074051。

摘　　要：目的:了解基层医务人员对分级诊疗制度实施情况的满意度状况并探讨其影响因素,为促进分级诊疗制度更好落实与发展提出合理化建议。方法:在江苏省海安市采取分层整群随机抽样方法抽取40家基层医疗机构468名基层医务人员进行问卷调查,采取描述性分析和分层分析的方法分析基层医务人员满意度的总体情况及存在的差异,采取有序多分类logistic回归分析影响满意度的因素。结果:28.21%、57.48%、12.17%和2.14%的基层医务人员对分级诊疗制度实施持非常满意、比较满意、不太满意和完全不满意的态度。人口学特征分层分析显示,不同地区、科室、年龄的基层医务人员对分级诊疗制度实施满意度存在差异。多因素分析结果显示,年龄、地区、对分级诊疗制度的了解和认可程度、转诊渠道通畅程度、对未来发展机会影响及有关分级诊疗制度的信息化建设程度是影响满意度的主要因素(P<0.05)。结论:基层医务人员对分级诊疗实施总体满意度较高,农村地区基层医务人员满意度低于城市地区基层医务人员,年龄较大的基层医务人员满意度偏低,提升基层医务人员对分级诊疗制度的了解和认可程度、畅通转诊渠道、加强信息化建设在一定程度上能够提升满意度。Objective:To understand the status of satisfaction of grassroots medical staff on the status of implementation of the hierarchical medical system and explore the influencing factors,so as to put forward reasonable suggestions for promoting the better implementation and development of the hierarchical medical system.Methods:A total of 468 grassroots medical staff from 40 grassroots medical institutions were selected by stratified cluster random sampling method in Hai'an city of Jiangsu province for questionnaire survey.Descriptive analysis and stratified analysis were used to analyze the overall situation and differences of grassroots medical staff's satisfaction,and ordinal logistic regression was used to analyze the factors affecting satisfaction.Results:There were 28.21%,57.48%,12.17%and 2.14% of grassroots medical staff who were very satisfied,relatively satisfied,dissatisfied and completely dissatisfied with the hierarchical medical system.The stratified analysis of demographic characteristics showed that there were differences in satisfaction with the implementation of hierarchical medical system among grassroots medical staff in different regions,departments and ages.The results of multivariate analysis showed that age,region,understanding and recognition of the hierarchical medical system,patency of upper and lower referral channels,influence on future development opportunities,and the degree of information construction of the hierarchical medical system were the main factors affecting the satisfaction of the hierarchical medical system(P<0.05).Conclusion:The overall satisfaction of grassroots medical staff on the implementation of hierarchical medical system is high,the satisfaction of grassroots medical staff in rural areas is lower than that in urban areas,and the satisfaction of older grassroots medical staffis lower.Improving the grassroots medical staffs understanding and recognition of the hierarchical medical system,unblocking referral channels and strengthening information construction can improve

关 键 词：分级诊疗制度 基层医务人员 满意度 影响因素 海安 

分 类 号：R197.1[医药卫生—卫生事业管理]