良性前列腺增生患者就诊需求的多水平模型分析

Study on health care demands of outpatients with benign prostatic hyperplasia using multilevel model

目的 研究老年科门诊老年良性前列腺增生（BPH）患者的不同就诊需求. 方法 采用自行设计的BPH门诊患者就诊需求调查表,对中国南、北方11个城市共33所三级甲等医院2027例60岁及以上BPH门诊患者与医务人员沟通需求、采用的检查项目需求、采用的治疗方案和健康指导方面的需求进行调查,并应用多水平模型进行分析. 结果 2027例BPH患者中,47.1％（955例）的患者认为医生开具检查项目前与其沟通很必要,39.8％（807例）的患者认为医生确定治疗方案前与其沟通很必要,19.2％（389例）的患者认为医生为其开具的检查项目是很必要的,36.0％（730例）的患者认为医生为其采用的各项治疗方案是很必要的,41.9％（849例）的患者认为医生对其进行BPH诊断方面的健康指导是很必要的,46.1％（934例）的患者认为医生对其进行BPH治疗方面的健康指导是很必要的.患者沟通需求、诊断需求、治疗需求和健康指导需求评分数据在南北方城市间具有聚集性,且下尿路症状越严重的患者其沟通需求和健康指导需求越强烈. 结论 在BPH临床诊治过程中考虑患者的就诊需求、医患双方共同选择合适的治疗方案,将有利于作出更科学的临床决策.

Objective To evaluate the patient＆#39;s health care demands in communication,diagnosis,treatment and medical counseling of geriatric BPH outpatients in China.Methods A survey study was carried out in 33 medical centers from 11 different cities in China （North：Lanzhou,Beijing,Shenyang; South：Chengdu,Changsha,Wuhan,Jinan,Nanjing,Hangzhou,Shanghai,Guangzhou）.2027 BPH outpatients aged （60 years participated in the survey to measure their health care demands using a questionnaire.Results There were 955 cases （47.1%） thinking communication is necessary before inspection items by a doctor,807 （39.8 %）thinking communication is necessary before determining the treatment program,389 cases（19.2%） thinking respection items by a doctor is necessary,730 cases（36.0%）the treatment program by a doctor is necessary,849 cases （41.9 %）thinking health guidance on BPH dignosis is necessary,934 cases （46.1 %）thinking health guidance on BPH treatment is necessary,The multilevel model showed the demands scores data is similarity among the north and the south.And the patients with more severe lower urinary tract symptoms have more demands on communication and medical counseling.Conclusions It is to get better therapy,considering the patient＆#39;s health care demands.