上海市松江区双向转诊知晓度与转诊意愿调查研究

Investigation on knowledge and willingness of dual referral in Songjiang District of Shanghai

目的了解上海市松江区医患双方对双向转诊的知晓度和患者的转诊意愿。方法收集上海市松江区内21所公立医院(1所三级医院、6所二级医院和14所一级医院)的400名医务人员和400名当日住院或门诊患者进行问卷调查,调查内容包括对双向转诊的知晓度、知晓渠道及患者的转诊意愿等。共回收医务人员问卷392份,回收患者问卷360份;分别采用描述性统计学分析、x^2检验和直线相关分析分别对医患双方对双向转诊的知晓度和知晓渠道进行比较,对患者的转诊意愿加以分析。结果医患双方对双向转诊的知晓度分别为95.9%和70.3%;大多数医务人员(92.0%)和患者(64.8%)通过医院培训或介绍知晓双向转诊,双方知晓渠道具有高度相关性(r^2=0.975,P<0.05)。对转诊意愿的调查显示,有85.3%的患者表示愿意转诊,9.7%的患者表示不愿意转诊;不愿意转诊者中31.4%的患者因担心医疗费用高而拒绝转诊。结论医患双方均对双向转诊有较好的认识,进一步在医疗机构内宣传双向转诊及完善双向转诊机制和流程有利于促进双向转诊。

Objective To investigate the knowledge of dual referral in hospital employees and patients as well as referral willingness in patients in Songjiang District of Shanghai. Methods Four hundred hospital employees and 400 outpatients or inpatients in 21 public hospitals of Songjiang District of Shanghai （ 1 first-class hospital, 6 second-class hospitals, and 14 third-class hospitals） were enrolled for dual referral questionnaires, and the investigation included knowledge of dual referral, channel to know dual referral and referral willingness. Three hundred and ninety-two questionnaires were recovered from hospital employees, and 360 from patients. Descriptive statistics, chi-square test and Pearson correlation analysis were employed to compare the the knowledge of dual referral and channel to know dual referral between hospital employees and patients, and analyse the referral willingness of patients. Results The knowledge of dual referral was 95.9% for hospital employees and 70.3% for patients. Most hospital employees （92.0%） and patients （64.8%） got to know dual referral through hospital propaganda, and their channels to get to know dual referral were highly related （ r^2 =0. 975, P 〈 0. 05）. Investigation on referral willingness revealed that 85.3% patients accepted dual referral, while 9.7% did not, and 31.4% of those who did not accept dual referral were due to the concern of high medical cost. Conclusion Both hospital employees and patients have good knowledge of dual referral, and dual referral may be promoted by propaganda enhancement and procedure optimization.