“三明医改”患者满意度调查研究

Investigation and Study on Patients' Satisfaction about “Sanming Medical Reform”

目的:为进一步深化医改提供科学依据和参考。方法:结合"三明医改"背景,采用自行设计的问卷对当地患者进行相关认知情况及满意度调查,并对调查结果进行统计和分析。结果:共发放纸质问卷275份,回收275份;并通过微信发放电子问卷,回收345份,共计回收620份,其中有效问卷372份,回收问卷有效率为60.00%。认为就诊费用减少的受访患者(31.45%)多于认为就诊费用增加的受访患者(22.31%),其中高收入者认为费用减少的比例显著高于低收入者(P=0.018)。27.42%的受访患者认为存在药品短缺,其中在三级医院比在其他类型医疗卫生机构更容易遇到药品短缺(P=0.062)。受访患者对医护人员和医改的满意度都较高,分别为86.56%和79.03%,其中农村患者对医护人员的满意度低于城镇患者(P=0.051)。受访患者对"三明医改"的了解程度总体上较低,仅有20.70%的受访患者完全了解或基本了解"三明医改"。受访患者中认为医护人员技术水平升高的(40.32%)多于认为医护人员技术水平降低的(5.91%)。结论:患者对"三明医改"的总体满意度较高,认同改革取得的成效,但仍存在部分药品短缺、基层医护人才匮乏、患者对医改政策不了解等问题。

OBJECTIVE： To provide the scientific evidence and reference for improving medical reform. METHODS： Based on background of ＂Sanming Medical Reform＂, self-designed questionnaires were used to investigate the cognition and satisfaction of local patients. The results of investigation were analyzed statistically. RESULTS： A total of 275 paper questionnaires were sent out and all were collected; 345 electronic questionnaires were sent out by Wechat and all collected. Among 620 questionnaires, 372 valid questionnaires were collected with effective rate of 60.00%. More patients （31.45%） thought the cost of treatment decreased, and less （22.31%） thought the cost increased. The proportion of high-income people who thought cost reduced was significantly higher than the proportion of low-income people （P=0.018）. 27.42% of patients believed shortage of drugs, and tertiary hospitals were more prone to drug shortage than other medical institutions （P=0.062）. The patients＇ satisfaction with medical staff and healthcare reform were both high （86.56% and 79.03% ）, but the satisfaction of rural patients was lower than that of urban patients （P=0.051）. Understanding of patients on ＂Sanming Medical Reform＂ was in low level. Only 20.70% of the patients fully understood or generally understood of ＂Sanming Medical Reform＂. The patients who thought the skills of medical staff were improved （40.32%）were more than those who thought the skills of medical staff were reduced（5.91% ）. CONCLUSIONS： Most patients are satisfied with ＂Sanming Medical Reform＂, and agree the achievements; but some problems are not solved, such as the shortage of some drugs, lack of grass-roots medical personnel, not understand medical policy.