患者对分级诊疗的认知及分级诊疗推行情况调查与分析

A Survey and analysis of Patients' Cognition of the Hierarchical Diagnosis and the Hierarchical Diagnosis Implementation

目的了解合肥市医院患者对分级诊疗的认知情况及患者的就医习惯,结合调查结果发现问题并提出建议,为完善分级诊疗制度提供参考。方法采用抽样调查的方法,抽取合肥市三甲医院及社区医院的360名患者进行问卷调查,共发放问卷360份,回收有效问卷338份,并对问卷进行统计分析。结果被调查的患者中,了解分级诊疗制度的患者有98人(28.9%);有112人(33.1%)患病时首选的就诊医疗机构为基层医院,了解分级诊疗的患者患病时更倾向于选择基层医院,与不了解分级诊疗制度的患者相比,差异有统计学意义(P<0.05);结论患者对分级诊疗的知晓率较低,对基层医院的认同感较低,转诊时存在转上而不转下现象,基层医院的服务水平及信息化程度有待提高。建议加强基层"软"实力与"硬"实力建设;加大分级诊疗的宣传力度;明确各级医疗机构功能定位,破除交叉竞争机制;扭转居民不科学的就医理念,促进分级诊疗制度的落实。

Objective By investigating the patients in hospitals of Hefei city, the study attempts to know the patients＇ cognition of the hierarchical diagnosis and their habits of seeking medical treatment. Based on the survey findings, some solutions to existing problems will be suggested to improve the hierarchical diagnosis system. Methods A questionnaire survey was conducted on 360 random patients in the 3rd-level hospitals and some community hospitals in Hefei city. A total of 360 pieces of questionnaire were delivered, while 338 pieces collected were effective. Statistical analysis was made on the questionnaires collected. Results Among the patients surveyed, 98 subjects （28.9%） are aware of the hierarchical diagnosis system.112 subjects （33.1%） would first choose a community hospital when they get ill. Compared with patients who do not know the hierarchical diagnosis system, those who know the system are more likely to seek medical treatment in a community hospital, and the differences are statistically significant（P〈0.05）. Conclusion Patients have a low awareness rate of the hierarchical diagnosis and lack a strong faith in primary medical institutions. They prefer to referral upward rather than downward. The service capabilities and information management degree of primary medical institutions remain to be improved. The proposals are to strengthen both ＂Soft Power＂ and ＂Hard Power＂ construction of primary medical institutions, improve publicity of the hierarchical diagnosis system, specify the functions of medical organizations of different levels, illuminate cross competition mechanism, change people＇s improper concepts of seeking medical treatment, and foster the implementation of the hierarchical diagnosis system.