签约家庭医生对天津市居民医联体认知的影响

Study on the Influence of Contracted Family Doctors on the Residents'Cognition of Medical Alliance in Tianjin

目的:探讨签约家庭医生对居民医联体认知的影响,为逐步实现分级诊疗模式提供依据。方法:采用方便抽样,从天津市32个医联体中抽取5个医联体(每个医联体调查1家牵头医院与1家社区卫生服务中心,共10家医疗卫生机构)。以当日前来就诊的居民作为调查对象进行问卷调查;运用倾向值匹配法与χ~2检验进行统计学分析。结果:样本匹配前,有27.5%的居民知晓医联体;样本匹配后,45.0%的居民知晓医联体。样本匹配后,特征变量(性别、年龄、受教育程度、是否参保、是否患慢性病、上转经历、下转经历)差异明显消除,匹配效果良好(P>0.05)。匹配后样本χ~2检验结果显示,是否签约家庭医生是影响居民医联体认知情况的因素(P<0.05)。结论:居民对医联体知晓程度不高,应该加强居民对医联体的了解程度;家庭医生影响居民医联体认知情况,应当承担起居民对医联体认知的重要作用,使居民形成基层首诊、双向转诊的就医思维,从而为顺利推行分级诊疗模式奠定基础。

Objective:To study the effect of the contracted family doctors on the residents'cognition of the medical alliance,and to provide the basis for the progressive realization of the hierarchical medical mode.Methods:Using convenient sampling,5 medical alliances(with 1 lead hospital and 1 community health service center,a total of 10 medical and health institutions)were selected from 32 medical alliances in Tianjin.The residents who came to the hospital were investigated by questionnaire.PSM and chi-square test were used for Statistical analysis.Results:Before sample matching,27.5%of residents knew about medical alliance.After sample matching,45.0%of residents were aware of medical alliance.After the sample matched,the difference of the characteristic variables(gender,age,education,whether participate in medical insurance,chronic disease,up-turn experience,down-turn experience)was obviously eliminated(P>0.05).The result of chi-square test showed that whether to sign a family doctor or not was a factor influencing the cognition of the residents'medical alliance(P<0.05).Conclusion:The level of residents'awareness of medical alliance is not high,and the residents'understanding of medical alliance should be strengthened.Family doctors have an influence on the residents’cognition of medical alliance,they should play an important role in improving residents'cognition of medical alliance,and promote residents to form the thinking of first consultation in primary hospitals and two-way referrals,so as to lay a foundation for the smooth implementation of hierarchical medical mode.