基于患者角度对陕北地区现行分级医疗制度运行情况的探究

Study on the Operation of the Current Classified Medical System in Northern Shaanxi from on the Perspeitive of Patient

目的对陕北地区市(县)镇医疗卫生机构的转诊患者进行问卷调查,分析患者在当前双向转诊制度中的得失和造成患者不合理分流现象的原因,探讨促进陕北地区分级医疗进一步完善的对策。方法运用分层抽样的方法,选取延安和榆林共六个县区的转诊患者作为研究对象,用编制的问卷进行调查。结果大部分患者对双向转诊制度持乐观态度,但由于基层的医疗环境难以得到广大患者的信任,导致市(县)级医疗机构仍是目前医疗服务任务的主要承担者。结论完善双向转诊制度,调整医疗保险政策、提高基层医疗机构卫生服务能力,并加大对双向转诊制度的宣传力度,对我地区医疗卫生事业的可持续发展具有重要意义。

OBJECTIVE To investigate the referral of patients in the cities-counties-towns medical and health institutions in northern Shaanxi, to analyze the causes and conditions of patients＇ unreasonable shunt in the current two-way referral system, and to discuss the countermeasures to promote the further improvement of the graded medical system in northern Shaanxi. METHODS A stratified sampling method was used to select the referral patients from six counties in Yan＇ an and Yulin as the subjects, and the questionnaire was used to investigate. RESULT Most patients were optimistic about the two-way referral system, however, due to the medical envi- ronment at the grassroots level was difficult to obtain the trust of the majority of patients, the municipal/county medical institutions were still the main tasks of the current medical service. CONCLUSION It was important to improve the two-way referral system, adjust the medical insurance policy, improve the health service capacity of the primary health care institutions, and increase the propaganda of the two-way referral system, which had great significance to the sustainable development of medical and health undertakings in our area.