我国基层首诊制现状及其效果的系统评价

Systematic assessment on the status quo and effect of primary level first diagnosis system in China

[目的]分析我国基层首诊制度实施现状及效果,总结影响基层首诊制度的因素和各地发展基层首诊制度的举措,为探索符合我国国情的分级诊疗制度提供理论依据和政策参考。[方法]采用文献分析法,共纳入36篇调查研究文献。[结果]基层首诊制度知晓率普遍不高,大多为40.00%~60.00%。基层首诊率各地区存在较大差异,江苏省(71.13%~82.10%)明显高于其他地区。基层首诊意愿普遍较高,北京(56.80%~83.40%)、上海(62.33%~79.80%)、广东(54.40%~89.65%)高于其他地区。影响居民基层首诊的因素包括:文化程度,年龄,机构可及性,对机构人员、设备、药品的信任度等。[结论]居民对基层首诊知晓率普遍不高,居民有较高的基层首诊意愿但受机构可及性,机构人员、设备、药品的信任度等因素影响,应加强政策宣传力度,创造良好的舆论环境;保障基本药物充分供给,合理整合区域医疗资源;大力发展基层卫生机构的医疗水平,提升其医疗服务能力。

Objective To analyze current situation and effect of the implementation of primary level first diagnosis system in China,summarize the factors influencing primary level first diagnosis system and the ways of carrying out primary level first diagnosis system in different regions,so as to provide theoretical basis and policy reference for exploring the hierarchical diagnosis and treatment system in line with China's national conditions.Methods A total of 36 research papers were included by literature analysis.Results Statistical analysis showed that the awareness rate of the primary level first diagnosis system was generally low,which was between 40.00%and 60.00%.There was larger difference in rate of primary level first diagnosis in different regions such as Jiangsu province was(71.13%-82.10%),which was significantly higher than that in other regions.The willingness of primary level first diagnosis was generally higher,such as Beijing was(56.80%-83.40%),Shanghai was(62.33%-79.80%)and Guangdong was(54.40%-89.65%)which were higher than other regions.The factors influenced primary level first diagnosis were education level,age,accessibility of institutions,credibility of institutions staffs,equipment and drug.Conclusions The awareness of residents primary level first diagnosis is general low.The residents have high willingness of primary level first diagnosis,but were influenced by the factors of accessibility of institutions,credibility of institutions staffs,equipment and drug.We should strengthen policy propaganda,create good public opinion environment.Ensure adequate supply of essential drugs,rationally integrate regional medical resources,strive to develop medical treatment level of grass root medical institutions,and promote medical care service ability.