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分级诊疗制度背景下徐州市居民基层首诊意愿分析
作者:李寒寒1  苗春霞1  卓朗1  王问海2  姜金星1  孙泓1  郑娟1  赵世鸿1 
单位:1. 徐州医科大学 卫生政策与健康管理研究中心, 江苏 徐州 221004;
2. 徐州市卫生与计划生育委员会 卫生应急办公室, 江苏 徐州 221004
关键词:分级诊疗 基层首诊 就医意愿 影响因素 
分类号:R197
出版年·卷·期(页码):2019·38·第二期(274-279)
摘要:

目的:通过了解徐州市居民基层首诊意愿情况,探讨分级诊疗制度背景下基层首诊的影响因素及原因等,不断提升基层首诊率。方法:采用分层随机抽样的方法进行结构式问卷调查。采用描述性统计,单因素、多因素Logistic回归分析进行数据分析,共发放问卷1 550份,有效回收1 473份,有效回收率为95.0%。结果:79.0%的居民选择基层医疗卫生机构,原因主要是距离近、收费低。病情较重时94.7%的居民选择综合医院,主要原因是医疗水平高、医保定点、医疗设备好。多因素Logistic回归分析结果显示,2015年月均收入低、医疗费用低、与基层医疗机构的距离近、与二三级医疗机构的距离远、有基层就医经历、支持分级诊疗制度、认为开展双向转诊有必要的居民首选基层首诊意愿较高。结论:徐州市居民基层首诊意愿逐渐形成,大病进医院意识不断完善,但仍需加强引导,提升基层优质服务。

Objective:To investigate residents' willingness of first diagnosis in community health service institutions(CHSI) and the influencing factors in Xuzhou, and improve the first rate.Methods:Residents were surveyed by a structured questionnaire. Descriptive Statistics, single factor analysis, and Logistic regression were applied to analyze data.95.0% of the questionnaires were effective. Results:79.0% residents were willing to accept the first treatment in the CHSI when they suffered from common diseases because of short distance, reasonable price; 94.7% residents were willing to accept the first treatment in hospitals when they suffered from serious diseases because of high quality, designated hospitals of medical insurances and large medical equipments. Binary Logistic analysis showed that residents preferred to first treatment in CHSI, who had lower average monthly income, lower medical costs, closer distance to primary medical institutions, far distance to general hospitals, experience of medical treatments in CHSI, and approving the hierarchical diagnosis and treatment system, the necessity of dual referral. Conclusion:Residents' willingness of first treatment in CHSI has been improved gradually, and the awareness that illness into hospitals improve constantly.

参考文献:

[1] 中共中央国务院.关于推进分级诊疗制度建设的指导意见[Z].2015.
[2] 杜若琪,葛炜,史勇红.基于国外分级诊疗模式探索我国分级诊疗实施措施[J].中国医疗管理科学,2017,7(6):5-10.
[3] 张靓,董恒进,郜琳,等.居民就诊意愿与基层医疗服务能力研究——以浙江兰溪为例[J].卫生经济研究,2016(8):19-22.
[4] 黄琦程,陆方,陈雯,等.医院患者对分级诊疗的认知调查及意愿分析[J].中国初级卫生保健,2016,30(7):1-3,34.
[5] 朱小凤,李道丕,刘中华,等.分级诊疗制度下患者就医意向的影响因素研究[J].中国医院,2017,21(1):34-37.
[6] 夏晓红,任毅,杨晓彤,等.居民社区首诊意愿及其影响因素研究——以南充市为例[J].卫生软科学,2015,29(10):619-622.
[7] 袁磊,赵志刚,王亚魁,等.北京市双向转诊制度实施情况及居民对基层医疗的满意度调查[J].中国全科医学,2017,20(7):216-219.
[8] 徐志伟,杨永光,张晓菊.分级诊疗制度的认知状况调查及其影响因素研究[J].河南医学研究,2017,26(16):2887-2890.
[9] 黄培,易利华.构建供应驱动视角下的双向转诊协同体系[J].现代医学,2014,42(5):536-539.

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