四川省医务人员对医联体服务需求和利用现状及其效果评价

Demand and utilization of and participation in medical alliance service among medical professionals in Sichuan province

目的了解四川省医务人员对医联体服务的需求和利用现状,评价其参与程度和效果,为促进该地区医联体建设发展提供参考依据。方法于2019年1月采用分层随机抽样方法在四川省21个地市州按照医院类别抽取1280名医务人员进行医联体服务问卷调查。结果四川省1280名医务人员中,对双向转诊、远程医疗、坐诊指导和人才培养等医联体服务需求比例分别为85.6%、74.7%、80.5%和81.3%,利用比例分别为32.1%、16.3%、24.5%和12.5%,差异均有统计学意义(均P<0.001);有411名医务人员参与了医联体服务,医联体服务参与比例仅为32.1%;411名医务人员中,认为服务效果较好和好的比例分别为41.8%和16.8%;参与医务人员认为医联体服务存在的主要问题为双向转诊管理流程问题(50.6%)和远程医疗患者需求问题(49.4%);未参加医联体服务医务人员的主要原因为没有管理部门通知(8.6%)、工作忙无时间参加(41.4%)、参与意义不大(28.9%)和想参与但机会少(21.1%)。结论四川省医务人员对医联体服务的需求和利用差距较大,参与比例较低。

Objective To examine the demand and utilization of and participation in medical alliance service among medical professionals in Sichuan province and to provide references for promoting the construction and development of medical alliance in the province.Methods Using stratified random sampling,we recruited 1575 medical workers in medical institutions at various levels in 21 cities or prefectures of Sichuan province for a face-to-face questionnaire survey in January2019.Results Among the 1280 respondents completing the survey,85.6%,74.7%,80.5%,and 81.3%reported the demands on services of two-way referral,telemedicine,consultation guidance,and talent training which could be provided by a medical alliance;the proportions of the respondents reporting the utilization of the four service items were 32.1%,16.3%,24.5%,and 12.5%,respectively;there were significant differences in the proportions of reporting both the demands and the utilization of the four service items(all P<0.001).Totally 411 respondents reported the participation in medical alliance service,with a participation rate of 32.1%.Of the respondents participating in medical alliance service,41.8%and 16.8%considered that the service resulted in generally good and good effect;50.6%and 49.4%regarded procedure management of two-way referral and patients′demand for telemedicine as the main problem in the operation of medical alliance.Among the respondents not participating in medical alliance service,41.4%,28.9%,21.1%,and 8.6%attributed the nonparticipation to not having time to participate due to busy work,disagreeing the necessity of medical alliance service,not having opportunity to be involved in the service,and not having been informed by administrative department.Conclusion There is a big gap in the demand and utilization of medical alliance service and the rate of participating in the service is low among medical professionals in Sichuan province.