实施分级诊疗对门诊患者就医意愿的影响研究

Study on the Influence of hierachical Diagnosis on Outpatient Patients’Willingness to Seek Medical Treatment

目的了解自贡市门诊患者对分级诊疗的认知情况,探讨不同认知情况对患常见病、多发病就医意愿的影响,为落实好分级诊疗制度提供参考依据。方法自行设计“自贡市门诊患者对分级诊疗认知情况及就医意愿调查表”,采用分层与方便抽样法,对自贡市一二三级医疗机构的门诊患者进行问卷调查。结果受调查患者对分级诊疗的知晓率为46.67%,赞成率为59.00%。患者对分级诊疗的知晓率、有无接受宣传对患常见病、多发病的就医意愿有影响(P<0.05),赞成率、可行度和有无双向转诊经历对患常见病、多发病的就医意愿选择无统计学差异(P>0.05)。结论各级医疗机构应加强分级诊疗政策宣传,明确不同等级医疗机构的功能定位,完善上下联动的机制,加快提升基层医疗机构的技术水平和服务能力,促进分级诊疗制度的深入推进。

OBJECTIVE To understand the cognitive status of outpatient patients in Zigong on hierachical diagnosis,and to explore the influence of different cognitive status on the willingness to see a doctor for common diseases and frequently-occurring diseases,so as to provide reference for the implementation of graded diagnosis and treatment system.METHODS Self-designed"Zigong City Outpatients’Cognition of Hierarchical Diagnosis and Treatment and Willingness to Seek Medical Treatment Questionnaire",the use of stratification and convenient sampling,the first,second and third medical institutions in Zigong city outpatients questionnaire.RESULTS The awareness rate was 46.67%,and the approval rate was 59.00%.The awareness rate of diagnosis and the acceptance of publicity had an impact on patients’willingness to seek medical treatment for frequentely-occurring common diseases(P<0.05).There was no statistical difference in the willingness to seek medical treatment for frequentely-occurring common diseases in terms of approval rate,feasibility and two-way referral experience(P>0.05).CONCLUSIONS Medical institutions at all levels should strengthen the publicity of hierarchical medical policies,clarify the functional positioning of medical institutions at different levels,improve the mechanism of linkage between the upper and lower levels,accelerate the improvement of the technical level and service capacity of grassroots medical institutions,and promote the in-depth promotion of hierarchical diagnosis system.