我国中部地区农村居民对县域三级医疗机构的认知评价

Cognitive Evaluation of Rural Residents in County Tertiary Medical Institutions in Central China

目的:了解我国农村居民对县域三级医疗机构的认知评价,剖析农村居民医疗服务利用的决策依据。方法:采用多阶段分层随机抽样方法,选择中部地区的安徽定远县、河南息县、湖北黄石市下陆区、河北任县、河南叶县等5地,对2187名居民开展问卷调查,描述性分析居民对村-乡-县三级医疗机构的认知评分与差异。结果:医疗技术方面县级医院评分远高于村-乡两级机构评分(6.07、6.70、8.20);服务与态度评分差别小并且集中(7.80、7.51、7.64)。经济负担重选项组对村-乡-县医疗费用评分最低(7.75、6.94、5.81)。结论:乡镇卫生院技术吸引力下降;村卫生室的费用和便捷优势、县级医院的技术优势均对农村居民有较高的吸引力,乡镇卫生院面临被忽视的风险。

Objective:To understand the evaluation of rural residents in China's tertiary medical institutions,to analyze the decision-making of medical service utilization of county residents.Methods:According to a multistage stratified random sampling method,2187 residents in five places were selected,including Anhui Dingyuan county,Henan Xi county,Hubei Xialu district,Hebei Ren county and Henan Ye county.To conduct a questionnaire survey,and descriptively analyze the scores and differences of residents at all levels of medical institutions.Results:In terms of medical technology,the scores of county hospitals were much higher than those of village and township two-level institutions(6.07,6.70,8.20),the differences between service and attitude scores were small and concentrated(7.80,7.51,7.64).The score of county-town-village medical cost in the group with heavy economic burden was the lowest(7.75,6.94,5.81).Conclusion:The technical capacity of township health centers shrinks and the technical attraction decreases.Village clinics have obvious advantages in cost and convenience,and the prominent technical advantages of county-level hospitals are highly attractive to county residents in the market.Township hospitals face the risk of being neglected.