摘要
目的了解住院患者对医患关系认知的现状及影响因素，为进一步有针对性地改善医疗服务提出政策建议。方法基于“全国改善医疗服务行动计划第三方评估”（2016-2017）136家公立三级医院的调查结果，分析住院患者医患关系认知现状及其主要影响因素。使用SPSS22．0软件对住院患者按重要基本信息进行医患关系认知评分差异的Kruskal—Wallis检验、Dunn—Bonferroni两两比较；使用SAS9．4软件对影响住院患者医患关系认知的因素进行二分类logistic回归分析。结果住院患者对“近2年来医患关系正在好转”的认同评分为（4．34±0．84）分，中位数为5．00分。男性住院患者对医患关系好转的认同度显著高于女性（P〈0．05）；住院前无固定内科或全科医生的住院患者对医患关系好转的认同度显著低于住院前有固定内科或全科医生者（P〈0．01）。住院患者的本次住院总体满意度（P〈0．01，OR=2．73）和医生有足够时间和患者沟通（P〈0．01，OR=1．84）是住院患者医患关系认知评分最显著的保护性影响因素，机构改善医患关系的过程和结构性指标评估结果（P〈0．01，OR=0．83）是对住院患者医患关系认知评分有显著影响的危险因素。住院前有固定内科或全科医生是住院患者对医患关系认知评分的另一保护性显著影响因素（P〈0．01，OR=1．31）。结论医生加强与患者沟通，改善医疗服务，提高患者总体满意度是提高住院患者对医患关系认知评分的首要措施。建立纠纷处理机制属于事后处理措施，医疗机构更应积极做好事前预防。另外，推进家庭医生制度与医疗联合体的融合，促进患者有自己固定的内科或全科医生，可以促进和谐医患关系的构建。
Objective To understand the current situation of inpatients＇ perceptions of doctor- patient relationship and its influencing factors, and to make policy recommendations for further targeted healthcare improvement. Methods Based on the survey results of the third party evaluation of the National Healthcare Improvement Initiative in 136 public tertiary hospitals, we analyzed the inpatients＇ perceptions of doctor-patient relationship. SPSS 22. 0 software was used to conduct Kruskal-Wallis test and Dunn- Bonferroni test, and SAS 9.4 was used to conduct multivariate logistic regression to analyze the influencing factors of inpatients＇ perceptions of doctor-patient relationship. Results The mean perception score of the inpatients pertaining to doctor-patient relationship was 4.34 ＋ 0.84, and the median was 5.00. The perception score of the male inpatients pertaining to doctor-patient relationship was significantly higher than that of the female respondents （ P 〈 O. 05） , that of the inpatients who had fixed physicians or general practitioners before visiting was higher than that of the inpatients who did not have （P 〈 0. 05）. The overall satisfaction of inpatients during hospitalization （P 〈 0. 01, OR = 2. 73 ） and doctors＇ satisfaction to have enough communication time with patients （ P 〈 0. 01 , OR = 1. 84） were the most significant protection factors to inpatients＇ perceptions of doctor-patient relationship. The process and structure evaluation results of hospitals in harmonization of doctor-patient relationship was a significant risk factor. Inpatients who had fixed physicians or general practitioners before visiting （P 〈0.01, OR = 1.31 ） was another statistically significant positive influencing factor of inpatients＇ perceptions of doctor-patient relationship. Conclusions It is imperative to strengthen communications between doctors and patients and to improve healtheare service, in order to raise patients＇ satisfactions for a harmonized doctor-patient relationship. In
出处
《中华医院管理杂志》
CSCD
北大核心
2018年第2期118-122,共5页
Chinese Journal of Hospital Administration
基金
国家卫生和计划生育委员会委托项目（2016）
关键词
住院患者
医生患者关系
认知
影响因素
回归分析
Inpatients
Doctor-patient relationship
Cognition
Influencing factors
Regression analysis
