医生与患者对全科医生综合素质评价的认知需求调查

Cognitive Analysis of Comprehensive Quality Evaluation of General Practitioners from Both Doctors and Patients

目的探讨我国医生和患者对全科医生综合素质评价的认知需求现状,以期为我国构建全科医生综合素质评价体系提供参考。方法采用方便抽样法,选取分布在我国34个省级行政区的192例医生和590例患者为调查对象。于2017-10-12至2017-10-31,采用自行设计的"关于全科医生综合素质评价的认知需求调查问卷",利用专业问卷调查网-问卷星进行调查并收集汇总资料。医生和患者共用一份问卷,问卷的主要内容包括:调查对象的基本情况、对全科医生综合素质评价的知晓情况及对全科医生的利用情况、对全科医生综合素质评价的重要性和可行性的认知情况、对全科医生综合素质评价的方式的认知情况。共发放问卷782份,回收有效问卷739份,问卷的有效回收率为94.5%。结果 739例医生和患者中,知晓全科医生综合素质评价者占19.9%(147/739);患病时去全科医生处就医比较方便/方便者占59.0%(436/739);选择全科医生的依据为自己经验判断者占33.6%(248/739);对获取便捷高效的选择全科医生途径的渴望程度的平均评分为(4.35±1.00)分。医生和患者对全科医生综合素质评价的知晓率、选择全科医生就医的方便程度、选择全科医生的依据(亲戚朋友介绍、自己经验判断、互联网或媒体)比较,差异有统计学意义(P<0.05)。739例医生和患者对全科医生综合素质评价的重要性、可行性评分分别为(4.17±1.02)、(4.06±1.04)分,对通过专家推荐、同行评价、医生自评、患者评价的方式进行全科医生综合素质评价的可靠性评分分别为(3.84±1.03)、(3.55±0.95)、(3.29±1.06)、(4.02±1.05)分。医生和患者对全科医生综合素质评价的重要性、可行性及对评价方式的可靠性评分比较,差异有统计学意义(P<0.05)。不同年龄、文化程度、身份、人均月收入、曾经到门诊看病总次数的医生和患者对全科医生综合素质评价的重要性评分比较,差异有统计学意义(P<0.05)。不同年龄、文化程度、身份、曾经到门诊看病总次数、曾经住院总次数的医生和患者对全科医生综合素质评价的可行性评分比较,差异有统计学意义(P<0.05)。结论医生和患者对全科医生综合素质评价的知晓率均较低,对全科医生综合素质评价的重要性、可行性评分较高。在我国建立一个基于互联网的、采用综合评价方式的全科医生综合素质评价体系将会是未来发展的趋势。

Objective To explore cognition and needs of comprehensive quality evaluation of general practitioners from doctors and patients in China,so as to provide reference for the construction of a comprehensive quality evaluation system.Methods A total of 192 doctors and 590 patients in 34 provincial administrative regions of China were selected as subjects by convenient sampling method.,A self-designed Cognition and Needs Questionnaire for Comprehensive Quality Assessment of General Practitioners was used to conduct surveys and collect data from 12 October 2017 to 31 October 2017,using Wenjuanxing,a professional questionnaire network platform.Doctors and patients used the same questionnaire.The questionnaire included basic situation of subjects,knowledge of comprehensive quality assessment of general practitioners,utilization of general practitioners,cognition of the importance and feasibility of comprehensive quality of general practitioners,and cognition of the way of evaluating the comprehensive quality of general practitioners.A total of 782 questionnaires were distributed,and 739 valid questionnaires were returned,with an effective recovery rate of 94.5%.Results Among the 739 doctors and patients,19.9%(147/739)of them were aware of the comprehensive quality evaluation of general practitioners;59.0%(436/739)of them were more convenient/convenient to see general practitioners when they were sick;33.6%(248/739)of them selected general practitioners based on their own experience;the average score of craving for a convenient and efficient access to general practitioners was(4.35±1.00)points.There were significant differences between doctors and patients in terms of awareness of overall quality of general practitioners,the convenience of selecting general practitioners,and the basis for selecting general practitioners(recommendation from relatives and friends,self-experience judgment,Internet or media recommendation)(P<0.05).The importance and feasibility scores of 739 doctors and patients for the comprehensive quality evaluation of general practitioners were(4.17±1.02)and(4.06±1.04)points respectively.The reliability scores of general practitioners'comprehensive quality evaluation by expert recommendation,peer evaluation,doctor self-evaluation,and patient evaluation were(3.84±1.03),(3.55±0.95),(3.29±1.06),and(4.02±1.05)points,respectively.There were significant differences between doctors and patients in terms of the importance and feasibility scores of comprehensive quality evaluation of general practitioners and the reliability scores of evaluation methods(P<0.05).The importance scores of comprehensive quality evaluation between doctors and patients in different ages,education levels,identities,monthly income per capita,and total number of outpatient visits and hospitalization were significantly different(P<0.05).Conclusion The awareness rate of comprehensive quality evaluation of general practitioners among doctors and patients is low,and the importance and feasibility scores of the comprehensive quality evaluation are relatively high.In China,the establishment of an Internet-based comprehensive quality evaluation system for general practitioners using comprehensive evaluation methods will be the future development trend.