门诊患者对分级诊疗制度认知状况的调查分析

A Survey on Cognition of Hierarchical Medical System among Outpatients

目的了解门诊患者对分级诊疗的知晓情况,为政府及不同级别医疗机构完善分级诊疗提供科学依据。方法选取在乌鲁木齐市3家三级甲等医院的510名门诊患者作为调查对象,采用自行设计的调查问卷进行调查,并对有效回收的497份问卷进行统计分析。结果 46.5%的患者知晓分级诊疗制度;有15.3%患者常见病会首选社区医院,有42.3%患者会首选三级医院;转诊经历中,88.5%患者没有经历过转诊;患者进行转诊时,63.2%由医生提出;患者转诊流程中,有29.8%的人认为是不顺利的,由于医保问题导致转诊不太顺畅的占到了33.3%;患者选择在三级医院首诊的原因中,有63.0%的患者认为医疗服务水平高,55.1%的患者认为软硬件技术好,39.8%的患者认为医疗环境好;患者如果到社区医院就诊,39.6%患者是因为就近方便;在社区医院应该加强的建设中,认为要加强医疗设备、提高治疗水平、提高医生技术分别占22.1%、26.2%、23.7%。结论应提高基层医疗卫生服务能力,扩大宣传,增强患者对分级诊疗制度的了解;加强医疗联动,建立科学合理的转诊流程;完善医保政策,倡导常见病首先到基层社区诊治的理念。

Objective To investigate the awareness and referral willingness of outpatients for hierarchical diagnosis and treatment,and to provide evidence for the government and different levels of medical institutions to improve hierarchical diagnosis and treatment.Methods A total of 510 outpatients from three tertiary hospitals in Urumqi were selected as survey subjects.A self-designed questionnaire was used among 497 participants for statistical analysis.Results 46.5%of the patients were aware of the hierarchical diagnosis and treatment system;15.3%of the patients had the preferred community hospital,42.3%of the patients preferred the tertiary hospital;as for the referral experience,88.5%of the patients did not undergo referral;when the patient was referred,63.2%were proposed by doctors;29.8%of the patients'referral process was considered to be unsatisfactory,and 33.3%of the referrals were not smooth due to medical insurance problems.As for the reasons for patients choosing the first diagnosis in tertiary hospital,63.0%of patients thought that the medical service level was high,55.1%of the patients thought that the hardware and software technology was good,39.8%of the patients thought that the medical environment was good.If the patient visited the community hospital,39.6%of the patients were because of the convenience.As for the construction of the community hospital that should be strengthened,it was considered that it was necessary to strengthen medical equipment,improve treatment levels,and improve doctors'technology by 22.1%,26.2%,and 23.7%,respectively.Conclusion It was necessary to improve the ability of primary health care services,expand publicity,enhance patients'understanding of the hierarchical diagnosis and treatment system,strengthen medical linkage,establish a scientific and reasonable referral process,improve medical insurance policies,and advocate common diseases to the primary community for treatment.