临沂市医疗卫生单位防御性医疗行为的现状研究

PRESENT SITUATION OF DEFENSIVE MEDICAL BEHAVIOR IN LINYI MEDICAL INSTITUTIONS

目的探讨临沂市防御性医疗行为的表现形式及相关影响因素。方法运用《临沂市防御性医疗行为调查问卷》对随机抽取的临沂市300名执业医师进行调查,比较医院级别、经历纠纷、职称、年龄、工作年限、科室、收入满意度等不同的医师防御性医疗行为情况。结果临沂市积极防御性医疗行为和消极医疗防御性行为都较突出,不同经历纠纷情况、职称、年龄、工作年限、科室、收入满意度的医师问卷得分差异有统计学意义(P<0.01),其中不同经历纠纷情况、科室分组在各级别医院中差异均有统计学意义(P<0.01),不同职称分组在一级、二级医院中差异有统计学意义(P<0.01),不同年龄、工作年限、收入满意度分组在二级、三级医院中差异有统计学意义(P<0.01)。结论临沂市防御性医疗行为现象突出存在,不同级别医院中主要影响因素不同。应针对不同级别医院采取措施,以提倡积极防御性医疗行为,抵制消极防御性医疗行为。

Objective To explore the present situation and the influence factors of the defensive medical behavior in the medical institutions of Linyi City. Methods 300 medical practitioners in Linyi medical insti- tutions were surveyed by using the Linyi Defensive Medical Behavior Questionnaire. Results There existed prominent positive and negative defensive medical behaviors involving dispute experience, technical title, age, years of working, departments and income satisfaction（ P 〈0.01）. The medical dispute experience and department affiliation produced significant difference in all levels of hospitals（ P 〈0.01）. The difference in technical titles could cause significant difference in first-level and secondary-level hospitals（ P 〈0. 01）. Age, years of working and income satisfaction groups could cause significant difference in secondarylevel and tertiary-level hospitals（ P 〈0. 01）. Conclusion There exist prominent defensive medical behaviors in Linyi medical institutions owing to different influencing factors in different levels of hospitals. Positive defensive medical behaviors should be advocated while negative defensive medical behaviors should be avoided.