四川省不同区域住院患者基层就诊现状及影响因素研究

Analysis of patients utilization of primary medical institutions and related factors among different districts in Sichuan Province

目的:了解不同区域住院患者的基层医疗服务利用情况,探讨其就医行为的影响因素,促进分级诊疗模式的有序构建。方法:采用多阶段分层抽样,对全省6个地市州18所医疗机构的住院患者进行问卷调查。调查内容包括:患者基本情况,对分级诊疗的认知情况,对基层医疗服务利用情况,对医保的认知及利用情况等。结果:患者对基层首诊的知晓率较低,为38.0%;基层卫生资源利用不足,仅56.3%的患者在过去一年有基层就诊的经历。不同区域住院患者的基本人口学特征、对基层医疗服务的认知及利用、选择基层就诊的影响因素等方面均存在差异,且差异有统计学意义。所有区域均显示患者在基层拥有固定医务人员能提高基层就诊率。结论:区域因素是影响患者选择基层医疗服务的重要因素,且不同区域影响患者基层就诊的因素也不尽相同。各区域应建立行之有效的引导机制,拉紧患者与基层医疗机构之间的纽带,促进基层就诊切实落到实处。

Objective:To know the status and influencing factors of using primary medical institutions among patients from different regions,and promote the construction of the hierarchical medical system.Methods:2592 patients were surveyed from 18 different medical institutions in 6 cities with the self-made questionnaire,including the general data,cognition and utilization of primary medical institutions and medical insurance.Results:Only 38.0%patients had the awareness of using primary medical institutions firstly,and the using rate is 56.3%in the past year.The results showed that demographic characteristics of patients from different regions are different,as well as the cognition and utilization of primary medical services,and the influencing factors of selecting primary medical services.Conclusions:Regional factors are important for patients'choice of primary medical services which are different in different regions.All regions should establish an effective guiding mechanism,tighten the link between patients and primary medical institutions,and promote the rate of primary medical services.