北京市不同级别医疗机构医患信任现状调查

Research on the Status of Doctor-Patient Trust in Different Levels of Hospitals in Beijing

目的:厘清不同级别医疗机构医务人员的工作现状及对医患信任度的评价,为改善医患信任水平及推进分级诊疗制度提供对策建议。方法:采用分层抽样法选取北京市6家不同级别的医疗机构,通过问卷调查及半结构化访谈对医务人员的工作量、医患信任及信任建立渠道等进行调查。结果:高级别医疗机构医务人员工作量高于低级别医疗机构,医患信任水平低于后者;三级医院有40.7%的医务人员每日诊疗人数多于41人,高于二级医院(30.4%)和社区卫生服务中心(31.2%),医患信任度总分(68.42分)低于二级医院(70.16分)和社区卫生服务中心(73.4分);三级医院医务人员认为医患信任以声誉型信任为主,二级医院和社区医院医务人员则将关系运作型信任列为首位。结论:工作强度影响医务人员对医患信任的评价;应积极推进分级诊疗,通过“双向转诊”夯实医患声誉型和关系运作型信任。

Objective:To explore the status of medical staffs and the evaluation of the doctor-patient trust in different levels of hospitals,and to propose the countermeasures and suggestions about the enhancement of doctor-patient trust and the promotion of hierarchical medical care.Methods:Six different levels of hospitals in Beijing were selected by stratified sampling method.The questionnaires and semi-structured interviews were used to investigate the current status of medical staff,the trust of doctors and patients,and the channels for establishing trust.Results:The workload in high-level hospitals was higher than that in low-level hospitals,and the level of doctor-patient trust was lower than that in low-level hospitals.40.7%of the doctors in tertiary hospitals treated more than 41 patients per day,higher than secondary hospitals(30.4%)and community health centers(31.2%),total score of doctor-patient trust in tertiary hospital(68.42)was lower than secondary hospitals(70.16)and community health centers(73.4).The doctors in tertiary hospital thought that doctor-patient trust was mainly based on reputation and institution,while the doctors in secondary hospital and community health center ranked relationship operation as the first.Conclusion:Work intensity affects the evaluation of doctor-patient trust by medical staffs,we should promote hierarchical medical care,and strengthen doctorpatient reputation and relationship operation trust through dual referral.