分级诊疗制度下居民就诊意向及相关因素分析

Analysis on residents′seeing doctor intention and related factors under hierarchical diagnosis and treatment system

目的分析分级诊疗制度下居民就诊意向及其相关因素,提出促进居民分级诊疗的对策建议。方法2016年调查江苏省6家医疗机构患者和家属869例,应用描述性统计、非参数检验和logistic回归模型分析调查数据。结果居民的基层首诊意愿较低;年龄、家庭收入和户口性质等个人因素影响居民的就诊意向,差异有统计学意义(P<0.05);医疗技术水平、距离远近、基础设备条件、服务态度等是居民就医选择的主要考虑因素。结论加强基层卫生经费投入和人才培养,推进医疗联合体的构建,提高基层医疗机构的服务能力和质量,以促进有序就医格局的形成。

Objective To analyze the residents′seeing doctor intention and related factors,and to put forward the countermeasures and suggestions for promoting the hierarchical diagnosis and treatment system for residents.Methods A total of 869 patients and family members in 6 medical institutions of Jiangsu Province were investigated.The descriptive statistics,non-parametric test and logistic regression were applied to analyze the survey data.Results The residents′willingness of the first seeing doctor in the community was low.The personal factors such as age,family income and household registration type affected the residents′seeing doctor intention(P<0.05).The medical technology level,distance,main equipment conditions,service attitude.Were the main considered factors of residents′seeing doctor selection.Conclusion Strengthening the funds inputting and personnel training of gross-roots medical institutions,promoting the construction of medical consortium and improving the service ability and quality of gross-roots medical institutions promote the formation of orderly seeing doctor pattern.