摘要
目的探讨分级诊疗制度对医疗机构医务人员的影响及认知状况。方法使用多阶段随机抽样法,从我国各地区抽取6个分级诊疗试点城市,从中抽取多家三级、二级医院、社区卫生服务、乡镇卫生院,再从中抽取执业医生、注册护士等528人作为调查对象。结果医务人员对于分级诊疗制度认知较深,认知率可达84.90%,三级医院医务人员认知率92.66%,高于二级医院85.07%、社区卫生机构75.00%、乡镇卫生院72.58%,差异具有统计学意义(P<0.05)。不同级别医务人员在收入、工作时间、工作负担、医患关系方面均存在差异,更多社区卫生机构和乡镇卫生所医务人员认为医患关系好转;经Logistic回归分析显示,护士、薪酬变化、医技是影响医务人员分级诊疗认知情况主要因素。结论明确各级医疗机构对分级诊疗制度推进的关键作用,关注基层医院,完善薪酬制度以提高医务人员积极性,能够进一步推动分级诊疗制度的开展。
Objective To explore the impact and cognitive status of the graded diagnosis and treatment system on medical staff at all levels of medical institutions.Methods Using a multi-stage random sampling method,6 pilot cities for tiered diagnosis and treatment were selected from various regions of China,and a number of third-level and secondlevel hospitals,community health services,and township health centers were selected,and 528 medical practitioners,registered nurses,etc.were selected.As the subject of investigation.Results The medical staff had a deeper understanding of the graded diagnosis and treatment system,with a cognition rate of 84.90%,the cognition rate of medical staff in the tertiary hospitals was 92.66%,higher than that in the secondary hospitals 85.07%,community health institutions 75.00%,township health centers 72.58%,The difference was statistically significant(P<0.05);Medical staff at different levels have differences in income,working hours,work load,and doctor-patient relationship.More medical staff in community health institutions and township health centers believe that the relationship between doctors and patients has improved;Logistic regression analysis shows that nurse,salary changes,medical skills are the main factors that affect the medical staff's level of diagnosis and treatment.Conclusion Clarifying the key role of medical institutions at all levels in promoting the grading diagnosis and treatment system,paying attention to grassroots hospitals,and improving the salary system to increase the enthusiasm of medical personnel can further promote the development of grading diagnosis and treatment system.
作者
徐未
易慧宁
XU Wei;YI Huining(Party and Government Office,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medicine School,Nanjing Jiangsu 210008,China)
出处
《中国卫生标准管理》
2021年第8期16-18,共3页
China Health Standard Management
关键词
分级诊疗制度
医疗机构
影响因素
医患关系
工作负担
基层医院
hierarchical diagnosis and treatment system
medical institutions
influencing factors
doctor-patient relationship
workload
primary hospital
