医防融合视角下慢性病患者对上下转诊服务的满意度及影响因素分析——基于江西省乡镇基层医疗机构的调查分析  

Services from the Perspective of Medical Prevention Integration Based on Survey of Township Primary Medical Institutions in Jiangxi Province

作　　者：李丽清[1] 翟小婷 孙克 邝骁睿 曾传美 Li Liqing(Health Policy and Development Research Center of Jiangxi Normal University of Science and Technology,Nanchang,P.R.China)

机构地区：[1]江西科技师范大学健康政策与发展研究中心,江西南昌330031 [2]江西省医院协会

出　　处：《中国卫生事业管理》2025年第1期107-112,共6页Chinese Health Service Management

基　　金：国家自然科学基金面上项目“健康中国视角下医疗资源配置与经济社会耦合协调发展的仿真模拟与预测评价研究”(72364016);国家社会科学基金重大项目“共享经济下构建我国分级医疗体系研究”(18ZDA085);国家卫生健康委健康中国建设揭榜攻关项目“分级诊疗视角下“医防融合”的重大慢性病健康管理模式与路径探索”(JKZGJBGG2305);江西省卫生健康委科技项目“健康中国视角下慢性病医防融合的协同机制与路径分析—基于江西的实践”(202410080)。

摘　　要：背景:慢性非传染性疾病成为当前我国面临最严峻的健康挑战和疾病负担的主要来源,其发病机制极为复杂,涉及遗传、环境、生活方式等多因素的交互作用,导致病程漫长且缠绵难愈。目的:明确医防融合视角下基层医疗机构慢性病患者对上下转诊服务的满意度现状及其影响因素,以期为优化转诊服务流程,提升服务质量提供有力的数据支持和参考依据,以实现为慢性病患者提供更精准、高效和人性化的医疗关怀。方法:采用分层随机抽样法,选择江西省内医防融合工作具有显著特色的婺源、万载、萍乡、九江等地区的乡镇基层医疗机构就诊的高血压和糖尿病患者进行问卷调查,旨在深入且全面地了解就诊患者对上下转诊服务的满意度及影响因素。通过独立样本检验、单因素分析及Kruskal-Wallis H检验分析组间差异,运用线性回归分析慢性病患者对上下转诊服务的影响因素。结果:本次研究共纳入2951例慢性病患者作为研究样本,其中1504例高血压患者、1447例糖尿病患者。高血压、糖尿病患者对于上下转诊服务满意度得分分别为4.32±0.77、4.21±0.82,整体满意度较高。从高血压患者问卷数据的回归分析结果显示,家庭年收入、医防融合服务认知、医防融合服务评价等是影响上下转诊服务满意度的因素(P<0.05);居住地、家庭年收入、医防融合服务认知、医防融合服务评价等是影响糖尿病患者对上下转诊服务满意度的因素(P<0.05)。结论:家庭年收入偏低的慢性病患者对上下转诊服务的满意度相对较高,医防融合服务的认知、评价情况与慢性病患者转诊满意度之间呈正相关关系。建议基层医疗机构强化医患信任,转变患者就医理念,构建以患者为中心的基层健康服务体系,加强全科医生综合素养,以高质量医疗服务提升患者对医防融合的评价,从而提高慢性病患者对转诊服�Background Chronic non-communicable diseases have become the most severe health challenge and the main source of disease burden in China,which have extremely complex pathogenesis,involving the interaction of multiple factors such as genetics,environment,and lifestyle,resulting in a long and persistent disease course.Objective To understand the satisfaction status and influencing factors of chronic disease patients in grassroots medical institutions with referral services from the perspective of medical prevention integration,provide strong data support and reference for optimizing the referral service process and improving service quality,and achieve more accurate,efficient,and humane medical care for chronic disease patients.Methods Stratified random sampling method was used to select the patients with hypertension and diabetes who visited the township medical institutions in Wuyuan,Wanzai,Pingxiang,Jiujiang and other areas,where has a distinctive feature of integration of medical treatment and prevention work in Jiangxi Province.A questionnaire survey was conducted to understand the patients'satisfaction with up and down referral services and its influencing factors,which was analyzed by using independent sample testing,univariate analysis,Kruskal Wallis H-test and linear regression.Results 2951 patients with chronic diseases were included in this study,including 1504 patients with hypertension and 1447 patients with diabetes.The score of hypertension and diabetes patients'satisfaction with up and down referral services was 4.32±0.77 and 4.21±0.82,respectively,indicating an overall high satisfaction.The regression analysis results from the questionnaire data of hypertensive patients showed that factors of family annual income,awareness of medical and preventive integration services,and evaluation of medical and preventive integration services could influence the satisfaction of referral services(P<0.05).And the factors influencing the satisfaction of diabetes patients with upper and lower referral services we

关 键 词：医防融合 慢性病 基层医疗机构 上下转诊 

分 类 号：R197[医药卫生—卫生事业管理]