北京市居民基层首诊意愿影响因素及促进策略研究  

Study on the Influencing Factors and Promoting Strategies of Residents'Willingness to Primary Initial Diagnosis in Beijing

作　　者：高永闯 邓剑伟[2] 贾凯琳 Gao Yongchuang(School of Labor and Human Resources,Renmin University of China,Beijing,P.R.China)

机构地区：[1]中国人民大学劳动人事学院,北京100872 [2]北京理工大学管理学院

出　　处：《中国卫生事业管理》2024年第10期1109-1113,1118,共6页Chinese Health Service Management

基　　金：北京市社会科学基金重点项目“数据驱动的北京分级诊疗政策执行的行为机制与效果评价研究”(22GLA009)。

摘　　要：目的:分析北京市居民基层首诊意愿和基本情况,探讨居民基层首诊影响因素,为促进基层首诊制度落实提供可借鉴建议。方法:基于文献自行开发调查问卷,采用随机抽样方法抽取800名北京市居民作为研究对象进行问卷调查,利用SPSS25.0开展单因素分析和多元回归分析等统计学分析。结果:社区医院距离远近、互联网就医方便程度和对上一轮医疗改革满意度等因素显著影响居民基层首诊意愿。高学历和老龄化群体基层首诊意愿不高,97.6%的慢性病患者不愿意基层首诊。结论:当前基层医疗机构布局不合理,互联网就医便捷性不高严重阻碍了居民基层首诊意愿,政府需要采取提高基层医疗机构数量等措施,社区医院要加速互联网就医建设,提升就医便捷性。慢性病患者过于依赖二级和三级医院,政府要加大资源倾斜力度,社区医院要多为慢性病患者考虑,做好慢性病归档管理工作。不同群体基层首诊意愿不同,政府和医院需要因“群”施教,重在引导,做好政策宣传和政策延续,从而落实基层首诊制度。Objective To analyze the willingness and basic situation of primary initial diagnosis of residents in Beijing,explore its influencing factors,and provide suggestions for promoting the implementation of basic initial diagnosis.Methods 800 residents of Beijing were selected by random sampling method as research objects for questionnaire survey,which was self-developed based on literature.SPSS 25.0 was used to conduct statistical analysis such as univariate analysis and multivariate regression analysis.Results Factors of the distance of community hospitals,the convenience of Internet medical treatment and satisfaction with the last round of healthcare reform significantly affected the willingness of residents to make the first diagnosis in basic healthcare centers.The highly educated and aged groups were not willing to make the first diagnosis in basic healthcare centers.97.6%of chronic patients were not willing to make the first diagnosis in basic healthcare centers.Conclusion At present,the unreasonable layout of primary medical institutions and the low convenience of Internet medical treatment have seriously hindered residents'willingness to seek first treatment at primary level.It is suggested for the government to take measures such as increasing the number of basic healthcare centers,and for community hospitals to accelerate the construction of Internet access to improve the convenience of healthcare.As for the chronic disease patients,who rely too much on secondary and tertiary hospitals,it is suggested for the government to increase the resource input,for community hospitals to give more consideration to chronic disease patients,and do a good job of chronic disease filing and management.And the government and hospitals need to take measures based on"group",focus on guidance,improve policy publicity and policy continuation,so as to implement the basic initial diagnosis policy.

关 键 词：北京市 基层首诊 社区医院 就医选择 政策建议 

分 类 号：R197[医药卫生—卫生事业管理]