摘要
目的:基于患者角度分析山西省县乡医疗卫生机构一体化改革政策的推进对基层医疗机构服务质量的影响,以期为其他地区改革提供参考。方法:以山西省运城市三县为例,利用初级卫生保健质量评价工具成人简短版(PCAT-AE)对患者进行调查,定量数据采用描述性统计和多元线性回归方法分析。结果:三县中一体化改革进展最久、落实程度最高的A县在核心维度中首诊(利用)(3.21)、连续性(3.02)、协调性(转诊)(3.08)得分最高,同时PCAT-AE总分最高(21.65);一体化改革进展次之的B县在核心维度首诊(利用)(3.02)得分上高于C县(2.52),且总分(20.74)高于C县(20.01);经多元线性回归分析,得分差异均有统计学意义(P<0.05);在各县中,面向社区这一维度与其他维度相比,得分最低。结论:一体化改革进展越久,落实程度越高,其基层医疗机构提供的服务质量越好,应持续深入推进一体化改革。
Objective Based on the perspective of patients,this paper analyzes the impact of the integration reform policy of county and township medical and health institutions in Shanxi Province on the service quality of basic medical institutions,with a view to providing reference for other regional reforms.Methods Taking the three counties of Yuncheng City,Shanxi Province as an example,the patients were investigated using the Primary Care Assessment Tools-Adult Edition(PCAT-AE).The quantitative data were analyzed by descriptive statistics and multiple linear regression.Results The A County,which has the longest progress in the integration reform of the three counties and the highest degree of implementation,has the highest in first consultation(utilization)(3.21),continuity(3.02),and coordination(referral)(3.08)in the core dimension,while PCAT-AE total score is the highest(21.65).In the second to the progress of integration reform,B County scored higher than C County(2.52)in the first consultation(utilization)(3.02)in the core dimension,and the total score(20.74)was higher than C County(20.01).After multiple linear regression analysis,the scores were statistically significant(P<0.05).In each county,the dimension for the community has the lowest score compared to other dimensions.Conclusion The longer the integration reform progresses,the higher the level of implementation,and the better the quality of services provided by its primary medical institutions,and the integration reform should continue to be further promoted.
作者
郝文丽
原效国
李建涛
张鑫苗
关超
杜茜蓉
闫凤茹
HAO Wen-li(School of Management,Shanxi Medical University,Taiyuan,P.R.China)
出处
《中国卫生事业管理》
北大核心
2020年第5期341-344,387,共5页
Chinese Health Service Management
基金
山西省高等学校哲学社会科学研究项目——人文社会科学重点研究基地项目(PSSR)“山西省县域医疗卫生服务体系整合模式研究”(201801018)
山西省卫生计一委科研课题“山西省县乡医疗卫生机构一体化改革理论研究”(2017003)。
