不同经济状况人群对医患关系认知差异性的调查分析

Investigation and analysis on cognitive differences of the physician-patient relationship among people in different economic situations

目的探讨不同经济状况人群对医患关系认知的差异性及其对策。方法随机入户问卷调查浙江省杭州、宁波、台州、湖州4个地区的城乡居民共1159人。结果有54.0%认为目前的医患关系和谐,38.5%认为目前医患关系紧张,且随着家庭经济收入水平的提高,认为医患关系紧张的比例随之下降,和谐的比例随之上升;医患关系紧张的主要原因在年收入5万元以下人群认为主要是医疗费用太高,其次是医患沟通不够,而年收入5万元以上人群认为主要是医患沟通不够,其次才是医疗费用太高;认为医疗费用负担水平重和无法承受的人群在年收入5万元以下达到42.4%,在年收入在5万元以上达31.1%;就诊时年收入在3万元以下与3-5万元人群首选中小医院,5-10万元与10万元以上人群首选大医院。结论不同经济状况人群对目前医患关系紧张程度、医患关系紧张的主要原因、医疗费用负担水平、选择医院标准等方面的认知存在明显差异。为改善医患关系,医患双方应进行积极交流和充分沟通,以求相互理解和配合;政府应加大对医疗卫生事业的投入,建立和完善全民医疗保障体系,大力扶持乡镇、社区医疗卫生服务体系,切实解决"看病难"、"看病贵"问题。

Objective To investigate cognitive differences of the physician-patient relationship among people in different economic situations and its countermeasure. Methods Random house questionnaire survey Was carried out in Zhejiang Province, and a total of 1159 urban and rural residents who lived in 4 areas of Hangzhou, Ningbo, Taizhou and Huzhou were investigated. Results 54.01% of residents thought the present physician-patient relationship was harmony, whereas, 38.48% of residents considered the present physician-patient relationship was anxious. The rate of residents considering anxious physician-patient relationship decreased along with the home economic income level enhancement. The main reason of poor physician-patient relationship among residents whose annual incomes were below 50,000 yuan was the high cost of health care, and the minor reason among them was the insufficient communication between physicians and patients. However, The main reason of poor physician-patient relationship among residents whose annual incomes were more than 50, 000 yuan was the insufficient communication between physicians and patients, and the minor reason among them was the high cost of health care. 42.35% of people whose annual incomes were below 50,000 yuan considered that burdens of heahh care were too heavy to endure, and so did 31.10% of people whose annual incomes were more than 50,000 yuan. The first choice of people whose annual incomes were below 30,000 yuan or from 30,000 to 50,000 was small or middle hospitals if they needed medical care, and the first choice of people whose annual incomes were more than 50,000 yuan was large hospitals. Conclusion There are cognitive differences of the poor physician-patient relationship degree, main cause, the burden of medical costs and the standards of choosing hospital among people in different economic situations. In order to improve physician-patient relationship, doctors and patients should communicate sufficiently so as to better understand and cooperate each other. The government should increase input in health care, establish and improve the universal health care system, and vigorously support the township and community health service system to effectively solve the the problems of ＂difficult treatment＂ and ＂expensive treatment＂.