分级诊疗视角下河南省农村居民常见病首诊机构选择行为分析

Analysis on Rural Residents' First Choice Behavior of Common Diseases under Hierarchical Medical System in Henan

目的:对河南省农村居民常见病首诊机构选择行为进行分析,探索影响农村居民就诊行为的因素,为完善基层首诊制度提供参考依据。方法:采用描述性统计分析对样本进行简单描述,采用多因素logistic回归分析对农村居民在患常见病时首诊机构选择的各种影响因素进行分析。结果:农村居民在患"感冒发烧"与"感冒发烧以外"常见病的就医行为方面存在不同,其差异有统计学意义(P<0.001);职业不同对"感冒发烧"首诊行为影响不同(P<0.05);文化水平不同对"感冒发烧"以外常见病首诊行为影响不同(P<0.001)。结论:常见病类型影响了居民的首诊行为,对于"感冒发烧",从事农业劳动的农村居民更倾向于基层首诊,对于"感冒发烧以外"的常见病,文化程度越高的村民越倾向于大医院首诊,收入水平并未成为农村居民常见病就医的障碍,首诊制的认知情况并未对农村居民首诊行为起到引导作用。

Objective： To analyze the rural residents＇ first choice behavior of common diseases, explore the factors that aflect the treatment behavior of rural residents in Henan Province. and provide references for the improvement of initial Medical Care. Methods： The descriptive statistical analysis was used to describe the sample, the muhivariate Logistic： Regression analysis was used to analyze the factors that influenced the selection of the first medical institution in the rural residents with common disease. Results： The rural residents＇ behavior had significant difference in ＂cold and fever＂ and ＂other common diseases＂（P〈0.001）; different occupa- tional effects on the first diagnosis of ＂cold and fever＂ was significant（P〈0.05）; different educational level effects on the first diagnosis of other common diseases was significant（P〈0.001）. Conclusion： The initial medical care of common diseases was influenced by the type of diseases, agrieuhural laborers preferred to primary diagnosis when they got ＂cold and fever＂; the well-educated rural residents preferred to go to the large hospital. The income level of rural residents has not become the obstacle of curing common disease, the cognition of initial medical care did not play a guiding role for the treatment behavior of rural residents.