合肥市居民就医机构选择意愿与影响因素分析

Analysis on residents'willingness to select medical institutions and its influencing factors in Hefei city

目的 了解合肥市居民就医意愿及影响因素,为加快构建有序的就医和诊疗新格局提供参考。方法 采用分层整群随机抽样,以现场问卷的方式进行调查,采用Epidata 3.1录入数据,应用SPSS 22.0进行数据分析。结果 单因素分析结果表明,年龄、常住地、学历、职业、家庭人均月收入、医保类型以及对分级诊疗的了解程度是居民在遇到一般疾病时医疗机构选择的影响因素(P <0.05)。年龄、常住地、婚姻状况、学历、职业、家庭人均月收入、医保类型以及对分级诊疗的了解程度是居民在遇到严重疾病时医疗机构选择的影响因素(P <0.05)。一般疾病下的多元logistic回归结果显示,学历、职业、分级诊疗了解程度对是否选择基层医疗卫生机构有显著影响,常住地和分级诊疗了解程度对是否选择县级及以上医院有显著影响。严重疾病医疗机构选择的多元logistic回归结果显示,常住地对是否选择县区级医院有显著影响,学历和分级诊疗了解程度对是否选择省市级医院有显著影响。结论 需提升基层医疗卫生服务水平,减少城乡差距;加强政策宣传,加快构建有序的就医新格局。

Objective:To understand the health seeking willingness of Hefei residents and its influencing factors,and to provide a reference basis for accelerating the construction of a newpattern of orderly medical treatment and diagnosis.Methods:In this study,stratified cluster random sampling was used to investigate the field questionnaire.Epidata3.1 was used to input the data,and SPSS 22.0 was used for data analysis.Results:The results of single factor analysis showed that age,permanent residence,education,occupation,household monthly income per capita,medical insurance type and understanding of hierarchical care are the influencing factors of residents'choice of medical institution when they face general diseases(P<0.05).Age,permanent residence,marital status,education,occupation,household monthly income per capita,medical insurance type and understanding of hierarchical care are the influencing factors of residents'choice of medical institutions when they face serious diseases(P<0.05).Multivariate Logistic analysis of medical institutions for general diseases showed that education,occupation and understanding of hierarchical care had a significant impact on whether to choose primary health care institution,and permanent residence and understanding of hierarchical care had a significant impact on whether to choose county-level and above hospital.The results of multivariate logistic regression of medical institutions for serious diseases showed that the place of permanent residence had a significant impact on the choice of county-level hospitals,and the education and understanding of hierarchical care had a significant impact on the choice of provincial and municipal hospitals.Conclusion:Improve the level of primary health care services,reduce the gap between urban and rural areas.Strengthen policy propaganda,accelerate the construction of a new pattern of orderly medical treatment.