摘要
目的了解分级诊疗制度下重庆市患者就医行为选择及影响因素,从服务利用者角度对推进分级诊疗制度建设提供参考依据。方法根据重庆市经济发展水平和医疗机构特征,选取6区县一、二、三级医疗机构共24家的患者作为调查对象,采用分层、方便抽样方法对各级医疗机构就诊患者共1556人进行问卷调查,访谈患者48人。结果62.1%的患者在患常见病、多发病之后选择到基层医疗机构就医,患者的年龄、现居住地、教育程度、月收入、就诊愿意花费时间、离最近基层医疗机构交通时间、基层医疗机构服务满足情况、分级诊疗制度知晓度、对分级诊疗制度的态度、家庭医生制度知晓度、双向转诊制度知晓度为患者基层首诊的主要促进因素。结论患者对分级诊疗的政策知晓程度是目前影响患者就医行为的重要因素,在完善政策的基础上,应采用多途径的深入宣传,增加患者对制度的知晓度和认可度,推进分级诊疗工作的开展。
Objective To investigate the patients’healthcare seeking behavior and influencing factors under hierarchical diagnosis and treatment system,and put forward suggestions to provide basis for promoting the construction of hierarchical diagnosis and treatment system from the perspective of service users.Methods According to the economic development level and medical institution characteristics of Chongqing City,1556 patients were selected by stratified sampling and convenience sampling from 24 medical institutions in 6 counties,and a survey was done through self-made questionnaire.48 patients was interviewed.Results The proportion of patients with the common disease who choose the primary medical institutions is 62.1%.The results show that age,residence region,education level,the average monthly in-come,willing clinic time,traffic time to the nearest primary care facility,satisfaction of primary care facility service,the cognitive situation of hierarchical diagnosis and treatment system,the attitude of hierarchical diagnosis and treatment system,the cognitive situation of family physician system,the cognitive situation of referral system are the main positive contributors to influence the flow of primary care facility.Conclusion The policy awareness of hierarchical diagnosis and treatment system is the importance influencing factor of healthcare seeking behavior.In order to promote the development of hierarchical diagnosis and treatment system,in addition to improving policies,it is more necessary to increase patient awareness and recognition of the system,and to further enhance the propaganda.
作者
汪曾子
刘娅莉
邱增辉
蒋祎
戴骄阳
朱佳妮
蒲川
WANG Zeng-zi;LIU Ya-li;QIU Zeng-hui(School of Public Health and Management,Chongqing Medical University/Research Cen-ter for Medicine and Social Development/Innovation Center for Social Risk Governance in Health,Chongqing,400016,China;不详)
出处
《中国医院管理》
北大核心
2020年第11期28-32,共5页
Chinese Hospital Management
基金
重庆市教委人文社会科学类研究项目(18SKGH014)。
关键词
分级诊疗
就医行为
影响因素
患者首诊
hierarchical diagnosis and treatment system
healthcare seeking behavior
influencing factor
patient first-treatment
