某市参合农民对乡村医疗机构服务质量的评价

Evaluation on Medical Service Quality of Rural Medical Institutions from Farmers in New Rural Cooperative Medical System in One City

目的了解参合农民对乡村医疗机构服务质量的评价,为改进乡村医疗机构服务质量提供依据。方法通过分层抽样和单纯随机抽样相结合的方法,抽取昆明市14个县(市、区)的部分参合农民进行问卷调查。结果昆明市参合农民对村卫生室、乡镇卫生院的医技水平、服务态度、医疗收费、医生可信度、设备、所需药品的评价均有统计学差异(P<0.05),对总体满意度评价没有统计学差异(P>0.05)。非条件Logistic回归分析表明,参合农民选择村卫生室的影响因素是医生服务态度、医生可信度、离家路程、总的医疗服务质量、需要的药品和总体满意度,选择乡镇卫生院的影响因素是医技水平、就医方便程度、离家路程及等待的时间。结论昆明市乡村医疗机构服务质量一般。建议相关部门合理配置卫生资源,加强乡村医疗机构(村卫生室、乡镇卫生院)的软硬件建设及管理,以提高乡村医疗机构服务水平。

Objective To explore the perception of quality of health care services provided by rural village clinics and township hospitals from famers who participating in rural cooperative medical system in 14 counties of Kunming city, in order to improve the quality of services of village clinics and township hospitals. Method Stratified random sampling and simple random sampling methods were used to select sample from 14 counties. Results famers perceptions were significant difference between village clinics and township hospitals on doctors＇ medical skills, attitude toward patients, fee for services, trust in doctors and equipments（P〈0.05）. And no significant difference on overall satisfaction between two level of medical institutes was found （ P〉0.05 ）. Logistic regression analysis showed that factors influencing farmers choosing village clinics to see doctor including doctor＇s attitude toward patient, trust in doctor, distance from home, the overall quality of medical services, availability of medicines, overall satisfaction with services. The factors affecting farmers＂ choosing township hospitals to see doctor included level of doctors＂ medical skills, convenience, distance from home and wait time. Conclusions Quality of health care services in village clinics and township hospitals need to be improved in study sites. Reasonable health resources allocation and strengthening the basic conditions of rural medical institutes （village clinics, township hospitals） should be taken in count by the concerned government departments.