湖北省城乡基层医疗机构患者寻医行为现状比较

Comparative Study on Patients' Health Seeking Behaviors of Primary Health Care Institutions in Hubei Province

目的:调查湖北省城乡基层医疗机构患者寻医行为的现状,科学分析患者寻医行为的特点,为有针对性地采取相应改革措施提供依据。方法:应用问卷调查的方法对城乡居民寻医行为进行调查,对城乡基层医疗机构的患者现状进行描述性统计分析,并对城乡基层医疗机构的患者寻医现状的差异进行检验或卡方分析。结果:湖北基层医疗机构医保覆盖率高,患者首诊选择基层的比例较高(城市73.5%,农村91.1%);患者对医疗保健知识的关注积极性不高,城市患者要显著高于农村患者(x2=32.69,P<0.01),获得途径均主要为电视;患者首先自我治疗的比例较高(城市61.5%,农村44.1%),城市显著高于农村(x2=10.96,P<0.01);农村患者对医疗服务的满意度要高于城市患者,两组不满意的原因都是觉得基层医疗机构技术低和设备差;农村患者的服药依从性(x2=8.02,P<0.05)和行为控制依从性(x2=5.54,P=0.02)都显著高于城市患者。结论:应改善患者获得医疗保健知识的渠道,提高基层医生的健康教育力度;依据基层医疗机构患者特点和疾病特点,引导患者作出合理医疗决策;规范治疗方案,提高患者遵医行为。

Objective： To investigate the status of the of patients＇ health seeking behaviors of primary health care institutions in Hubei province, describe the characteristics of the patients＇ health seeking behaviors, provide the proofs for taking appropriate health reforms. Me- thods： The questionnaire survey was used, descriptive statistical analysis on the patients＇ status and health seeking behaviors. T-test or chi- square analyses were used to test the differences between two groups of urban and rural patients. Results： Health insurance coverage of Hubei primary health care institutions is large. Primary health care institutions is mainly the first choice （73.5% in urban, 91.1% in rural）. Patients have litter enthusiastic for seeking health knowledge and urban patients is significantly better than rural areas＇ （X^2= 32.69, P〈0.01）. The first way to get health information is television. Self healing is the first choice （61.5% in urban, 44.1% in rural）, the proportion of city was signifi- cantly higher than rural （X^2 = 10.96, P〈0.01）. The satisfaction of the rural patients for medical services is higher than urban patients. Two groups are not satisfied with the same reasons for poor primary health care technology and equipment. Rural patients＇ medication adherence （X^2 = 8.02, P〈0.05） and behavior control compliance （X^2 = 5.54, P=0.02） were significantly better than urban patients＇. Conclusions： Improve the chance for the patients accessing to health care knowledge, and made great efforts to improve doctors＇ ability of health education. Guide Pati- ents to make reasonable medical decisions based on patient characteristics and disease characteristics of the primary health care institutions. Launch standard treatment program to improve patient compliance behavior.