江苏省患者社区首诊和双向转诊现状分析

Analysis on current status of preliminary diagnosis in community and dual referral in Jiangsu Province

[目的]调查和分析江苏省医院就诊患者的社区首诊及双向转诊情况,发现问题并提出合理化建议。[方法]采用方便抽样方法抽取江苏省内381例住院及门诊患者进行问卷调查,利用描述性统计、非条件logistic回归分析法分析就诊患者的转诊意愿及其影响因素。[结果]疾病较轻时患者首诊机构选择社区医疗机构的占54.3%,选择省、市级医院的占26.8%,选择区(县)级医院的占17.6%;有过社区医疗机构就诊经历的患者占54.6%,对社区基层医院的满意度为57.6%;社区医疗机构和大医院间的上转率和下转率分别为22.6%和6.8%。[结论]社区医疗机构服务利用率低,居住地离医疗机构的距离影响着首诊医疗机构的选择,患者对社区基层医院的满意度不高,上转和下转率低。

Objective To investigate and analyze the status of preliminary diagnosis in community and dual referral of patients in Jiangsu province,find the problems and put forward rationalization proposal.Methods It used convenience sampling method to select 381 outpatient and hospitalized patients and conduct questionnaire survey,patients referral desire and the influencing factors were analyzed with descriptive statistics and chi-square test and 1ogistic regression.Results When suffered minor diseases,54.3% of patients chose community health service institutions,26.8% of patients chose provincial or municipal hospitals,17.6% of patients chose district hospital.54.6% of patients had experience in community health service institutions and 57.6% of patients were satisfied with community health service institutions.The rate of upward referral was 22.6% and the rate of downward was 6.8% between community health service institutions and hospitals.Conclusions The utilization ratio of community health service institution is low.The distance of residence from medical institution influence preliminary diagnosis choice.The satisfaction of patients to grass roots medical institution is low,the rate of upward and downward referral is as well.