浅谈分级诊疗制度在赣州的推广应用

Popularization and application of hierarchical diagnosis and treatment system in Ganzhou

目的探究分级诊疗制度在赣州的推广应用。方法选取2017年6月至2017年10月期间,同意参与本次实验的865例患者开展调研。所有参加实验的对象中,有432例来自于医院,433例来自于社区卫生中心。针对所有患者发放首诊、转诊意愿调查表、不同特征社会居民社区首诊意愿调查表、居民不愿由社区转诊情况调查表和转诊满意情况调查表。结果据调查居民愿意在社区卫生服务中心首诊的比率为44.05%,与其他不愿意患者相比,差异具有统计学意义(P<0.05)。社区首诊情况分析中可知,男性、年龄36～50岁、本科以上学历群体更能够接受社区首诊。其与女性;年龄≤35岁、51～60岁、≥61岁;小学、初高中、大专文凭相比,差异具有统计学意义(P<0.05)。不能自由选择转诊医院,对社区硬件设施不满意作为居民不愿转诊的原因,严重影响着转诊率。而患者对治疗结果满意度为95.98%,高于转诊费用,差异具有统计学意义(P<0.05)。结论赣州居民社区卫生中心首诊意愿较低,且普遍不爱转诊。为此需要提高社区基本医疗水平,提高居民就医认识,才能够保证分级诊疗制度得以推行,以便于居民更好的利用医疗资源。

Objective To explore the popularization and application of hierarchical diagnosis and treatment system in Ganzhou.Methods From June 2017 to October 2017,865 patients who agreed to participate in the experiment were investigated.Of all participants,432 came from hospitals and 433 from community health centers.For all patients,the first visit,referral willingness questionnaire,community first visit willingness questionnaire with different characteristics,community referral unwillingness questionnaire and referral satisfaction questionnaire were issued.Results According to the survey,the proportion of residents willing to first visit the community health service centers was 44.05%.Compared with other unwilling patients,the difference was statistically significant(P<0.05).According to the analysis of community first visit,male,36-50 years old and above undergraduate education group are more able to accept community first visit.Compared with female,age≤35,51-60,≥61,and Diploma of primary school,junior high school and junior college,the difference was statistically significant(P<0.05).Referral hospitals can not be freely chosen,and dissatisfaction with community hardware facilities is the reason why residents are reluctant to refer,which seriously affects the referral rate.The patients'satisfaction with the treatment results was 95.98%,which was higher than the cost of referral,and the difference was statistically significant(P<0.05).Conclusion Ganzhou residents'community health centers have low willingness to first visit,and generally do not like referral.Therefore,it is necessary to improve the basic level of community health care and residents'awareness of medical treatment in order to ensure the implementation of graded diagnosis and treatment system,so as to facilitate residents to better use medical resources.