徐州市城市居民分级诊疗制度认可状况及其影响因素
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摘要
目的:了解徐州城市居民对分级诊疗制度的认可状况及影响因素,为促进分级诊疗制度的实施提供建议。方法:采用多阶段分层随机抽样的方法,选取徐州市无认知障碍的城市成年居民进行问卷调查;采用描述性统计、卡方检验和Logistic回归等方法进行数据分析。结果:65.9%城市居民认可分级诊疗;多因素分析显示,年龄、月均收入、自评健康状况、健康体检、基层就医经历等影响居民对制度的认可。基层首诊、双向转诊赞成率分别为51.4%和53.9%,居民对基层服务能力不满意;知晓分级诊疗者更赞成基层首诊(57.9%)和双向转诊(57.9%),曾在基层就医者更赞成基层首诊(72.4%),无转诊经历者更支持双向转诊(57.4%)。结论:分级诊疗制度的优越性已逐步被认可,但支持率低。当前应该提升基层服务能力,完善政策配套措施,注重政策的执行。
Objective: To investigate urban residents' approval and its influencing factors of the tiered healthcare system in Xuzhou, so as to propose suggestions to improve the implement of the system. Methods: The adult urban residents who have no cognitive impairment were selected by multistage stratified random sampling method in Xuzhou. Descriptive statistics, chi-square test and logistic regression analysis were used for data analysis. Results: 65.9% of the residents supported the system. Multivariate logistic regression analysis showed that the influencing factors consisted of age, average monthly income, self-perceived health status, checkup, primary medical experience, etc. Unsatisfied with the service capabilities of the health clinics in towns or villages, 51.4% favored community health service as first choices, and 53.9% favored the dual referral system. Residents who were aware of the system had more support for the first treatment in primary medical institutions(57.9%) and the two-way referral(57.9%). Residents were more supportive for the primary medical treatment with experience in the past(72.4%), and more approval were indicated with no referral for the two-way referral system(57.4%). Conclusion: Although low approval rating, the system is recognized progressively. The urgent job is to improve the service capabilities of primary medical institutions and to enforce policies and further implement.
Objective: To investigate urban residents' approval and its influencing factors of the tiered healthcare system in Xuzhou, so as to propose suggestions to improve the implement of the system. Methods: The adult urban residents who have no cognitive impairment were selected by multistage stratified random sampling method in Xuzhou. Descriptive statistics, chi-square test and logistic regression analysis were used for data analysis. Results: 65.9% of the residents supported the system. Multivariate logistic regression analysis showed that the influencing factors consisted of age, average monthly income, self-perceived health status, checkup, primary medical experience, etc. Unsatisfied with the service capabilities of the health clinics in towns or villages, 51.4% favored community health service as first choices, and 53.9% favored the dual referral system. Residents who were aware of the system had more support for the first treatment in primary medical institutions(57.9%) and the two-way referral(57.9%). Residents were more supportive for the primary medical treatment with experience in the past(72.4%), and more approval were indicated with no referral for the two-way referral system(57.4%). Conclusion: Although low approval rating, the system is recognized progressively. The urgent job is to improve the service capabilities of primary medical institutions and to enforce policies and further implement.
引文
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[2]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.
[3]马千惠,高广颖,那春霞,等.新型农村合作医疗分级诊疗制度医患双方认知情况分析[J].中国卫生经济,2016,35(10):39-42.
[4]崔华欠,方国瑜,杨阳,等.广州市城市居民对分级诊疗模式的知晓和认知情况调查[J].中国全科医学,2014,17(34):4123-4126.
[5]蒋婉英,王芳,许晓敏,等.关于推进绍兴市分级诊疗服务体系建设的思考[J].管理观察,2016(3):179-181.
[6]陈美婷,梅文华.我国社区首诊制发展现状及居民社区首诊影响因素分析[J].医学与社会,2016,29(4):24-26.
[7]于洗河,万龙涛,顾文涛,等.吉林省县级公立医院患者分级诊疗认知状况调查[J].医学与社会,2017,30(12):11-14.
[8]武瑞仙,蔡玥,兰蓝,等.2008—2015年我国城乡基层卫生资源配置变化趋势分析[J].中国卫生资源,2017,20(3):205-208.
[9]杨婧怡,冯跃林.重庆市医务人员分级诊疗制度认知现状调查[J].医学与社会,2018,31(4):4-6.
[10]潘子晶,柴慎华,高梦阳,等.我国农村居民首诊机构选择及影响因素分析[J].医学与社会,2017,30(7):8-10.
[11]赵忠辉,苗春霞,卓朗,等.徐州市社区居民分级诊疗制度知晓情况及影响因素研究[J].中国全科医学,2017,20(25):3094-3098.