摘要
目的分别从医师、患者和调查者的角度综合分析四川省基层卫生服务的可及性现状,并提出相关政策建议。方法 2017年11月-2018年2月基于欧洲基层医疗质量和成本中心基层医疗服务调查问卷,采用多阶段分层抽样,分别从四川省不同区域选取6个市(州),合计48家基层医疗卫生机构,从患者、医师和调查者三者角度对基层医疗服务可及性进行现场调查,并对相应问卷条目赋值,计算综合可及性分数对其可及性现状进行评价。结果有效调查了319名基层医疗机构的执业医师和641例在基层医疗机构就诊的患者。将患者和医生调查问卷对应条目赋值计算综合可及性分数后,可以得到6个抽样地区基层医疗服务可及性总体平均中位水平为0.25,经济中等地区(0.30)和经济发达地区(0.28)可及性较好,经济欠发达地区(0.23)可及性稍差。结论虽然整体抽样地区基层服务可及性尚可,但问卷调查结果显示,经济欠发达地区的可及性仍然存在很多问题。四川省在基层医疗的可及性方面依然有很大的进步空间,需有针对性地采取措施,有效提高基层医疗服务可及性,促进人人享有基本医疗卫生服务目标的实现。
Objective To analyze the accessibility of primary care in Sichuan Province from both the perspective of doctors, patients, and field workers, and then make some policy recommendations. Methods Based on the Quality and Costs of Primary Care in Europe primary care questionnaire, we surveyed 48 primary care facilities from six cities/states in Sichuan by multi-stage stratified random sampling method, taking in account of the regional development level from November 2017 to December 2018. Then integrated accessibility score for primary care was calculated based on the question items for both doctors and patients. Results This study effectively surveyed 319 primary care doctors and 641 patients. In general, the integrated accessibility score for primary care for these areas was 0.25. The accessibility of primary care was worst in less-developed regions(0.23), while it was much better in medium-developed area(0.30) and developed area(0.28). Conclusions We can do lots of things to improve accessibility of primary care. Evidence based policies are needed to promote this goal that everyone will have access to basic medical and health services.
作者
杨华珍
曾文麒
王桾蔓
李竹月
文进
张蕾
YANG Huazhen;ZENG Wenqi;WANG Junman;LI Zhuyue;WEN Jin;ZHANG Lei(West China School of Public Health,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Institute of Hospital Management,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2019年第12期1368-1373,共6页
West China Medical Journal
基金
国家自然科学基金(71874115)
四川省科学技术厅科技计划项目(2018KZ0046)
关键词
基层医疗服务
可及性
抽样调查
Primary care
Accessibility
Sample investigation
