医联体下分级诊疗模式协同机制思想动态的研究

Study on the Dynamics of the Cooperative Mechanism of the Hierarchical Diagnosis and Treatment Model under Medical Association

目的从供需双方的角度了解市医院区域医联体建设中,居民及医务人员的思想动态状况以及存在的问题,并据此提出对策和建议。方法采用分层随机抽样方法,应用自行设计的调查问卷进行问卷调查,随机抽取市医院区域医联体建设下10家社区卫生服务中心、2家二级医院医务人员各50名;医联体下辖区居民300名,在问卷调查过程中进行严格的质量控制。结果辖区居民对医联体的认知度不高;研究中社区居民对医联体分级诊疗模式满意率仅占48.77%,分级诊疗的效率有待提高;医务人员调查中,医务人员对医联体知信行水平不足,三级医院医务人员对医联体非常了解率高于社区医疗机构,差异有统计学意义(P<0.05);三级医院以及社区医院医务人员认为医联体对自身工作的帮助评价差异无统计学意义(P>0.05)。结论医联体下分级诊疗模式协同机制仍有许多基础问题未能得到解决,社区居民对其认可度有待提高,医务人员对其积极性有待增强。

Objective To understand the ideological status and existing problems of residents and medical staff in the construction of the medical associations in the city hospital from the perspective of both supply and demand, and to propose countermeasures and suggestions accordingly. Methods Stratified random sampling method was used to conduct a questionnaire survey using self-designed questionnaires. 50 medical staff from community health service centers and 50 medical staff from 2 secondary hospitals in the hospital＇s regional medical associations were randomly selected; there are 300 residents under the jurisdiction of the district and strict quality control during the questionnaire survey. Results The residents of the area have poor recognition of the medical associations; the community residents＇ satisfaction rate for the medical grading diagnosis and treatment model only accounts for 48.77%; the efficiency of the grading diagnosis and treatment needs to be improved; the survey of medical staff in the medical association showed that their knowledge of medical association is insufficient, the medical staff of tertiary hospitals have better understanding of the medical association than the staff of community hospitals, and the difference is statistically significant（P〈0.05）. However, there is no statistically significant difference in the evaluation of the help of the medical association for their work between medical staff of tertiary hospitals and community hospitals.（P〉0.05）. Conclusion There are still many basic problems need to be solved of the coordination mechanism of the hierarchical medical treatment model under the medical association. The recognition of the community residents needs to be improved, and the enthusiasm of the medical staff also needs to be enhanced.