影响医生诊疗行为的患者因素探讨

An investigation of patients factors in the effects on clinicians diagnosis and treatment behavior

目的 探讨患者因素对临床医生诊疗行为的影响并判断其大小。方法 从济宁市三级医院中随机选取310名医生,调查患者经济状况、自行处方等因素对医生诊疗行为的影响。结果 患者自行处方（β=-0.03851）、隐瞒病史（β=-0.70214）、医患关系紧张对医生的诊疗行为规范化呈负作用;而患者反馈评价（β=0.47564）、加入医疗保险（β=0.47078）和患者自身的经济状况（β=-0.03851）有利于促进医生的诊疗行为向着规范化方面发展。结论 应该针对患者因素对医生诊疗行为的影响,限制患者自行处方和隐瞒病史,融洽医患关系,建立规范的患者反馈系统并推动医疗保险事业发展,充分利用患者因素的积极作用加强诊疗规程落实,从而促进诊疗行为规范化。

Objective To explore how and to what extent patients influences clinicians＇ diagnosis and treatment behavior. Methods 310 clinieians randomly selected according to employee ID among different grades hospitals in Jining city were randomly selected, and to determine how clinicians＇ practise is infected by patients with questionnaire. Results Self-diagnosis and self-prescription（ β= -0.0385 ） ,as well as disguising history（ β = -0.70214） and tension between doctors and patients（ β = -0. 24139） is negative for standardization, while affirmative feedback from the sick（ β = 0.47564） ,buying insurance（ β = -0. 47078 ） and being in good economic condition is （ β = - 1.41179 ） positive correlation to diagnosis and treatment behavior standardization. Conclusion Measurements should be taken to restrict self-diagnosis and self-prescription of patients and harmonize patients-doctor relationship, and erect normal feedback system ,as well as impel progress of basal medical insurance to make full use of the positive effect of patients in order to promote the standardization of clinicians＇ diagnosis and treatment behavior.