工伤保险门诊定点服务政策下职业病患者就医影响因素分析

Analysis on influential factors on medical services in occupational disease patients under policy of designated outpatient service of work-related injury insurance

目的了解工伤保险门诊医疗实行定点服务管理的新政策下职业病工伤患者选择定点医院门诊就医行为及影响因素,更好的为职业病工伤患者服务,同时为制定职业病工伤定点医院工作指导意见提供参考依据。方法自行设计调查问卷,选取2021年济南市3家工伤保险职业病定点医疗机构的职业病患者进行抽样调查问卷,调查职业病患者的基本情况、选择医院及医生的影响因素,并对数据进行分析。结果患者选择医院的影响因素中,患者最为关注的是医院药品是否齐全,其次是医院服务态度以及医院是否有专家名医等,得分分别为831、827和819分。患者选择医院医生的影响因素中,患者最为关注的是医生的技术水平,其次为医生的临床经验及医生服务态度,得分分别为914、876和834分。对患者关注度居前几位的6项影响因素中,医院药品齐全、医生技术水平、医生临床经验3项因素,不同年龄的患者选择率比较,差异均有统计学意义(χ^(2)=28.137、15.237、31.868,均P<0.01);对医院药品齐全、医院有专家名医、医院服务态度、医生技术水平、医生临床经验5项因素,不同文化程度的患者选择率比较,差异均有统计学意义(χ^(2)=40.040、13.462、17.797、13.382和12.866,均P<0.05)。但是医院药品齐全、医院有专家名医、医院服务态度、医生技术水平、医生临床经验、医生服务态度6项因素,不同收入水平的患者选择率比较,差异均无统计学意义(均P>0.05)。结论职业病工伤定点医院应该开展全方位、多层次的医疗服务,在充分保障不同职业病患者用药需求的基础上,着重提高医务人员技术水平和服务态度,充分发挥专家名医的专业支撑作用,满足职业病患者日益增长的医疗需求,同时职业病工伤管理部门应发挥好监督管理作用,更好地为职业病患者服务。

Objective To study the medical care behavior and influential factors on patients with occupational diseases and work-related injury under the new policy of designated outpatient service management of work-related injury insurance,provide the reference basis for better service to patients and formulating the work guidance of designated hospital for occupational diseases and work-related injury.Methods By using a self-designed questionnaire,the occupational disease patients were collected from three designated medical institutions for work-related injury insurance in Jinan City in 2021 for a sampling questionnaire survey,to explore the basic condition of patients,the influential factors of hospital selection and doctor selection,and the data were analyzed.Results In the perspective of influential factors for patients'choice of hospitals,they were most concerned about drugswell-equipped,followed by the service attitude of medical staff and famous experts,the scores were 831,827 and 819points,respectively.From the perspective of influential factors for patients'choice of doctors,they were most concerned about the medical technology level,followed by the clinical experience and service attitude,the scores were 914,876 and 834 points,respectively.Among the top six factors of patients'concern,there were statistically significant differences in the selection rates of drugswell-equipped,the medical technology level and the clinical experience among different ages(χ^(2)=28.137,15.237,31.868,all P<0.01).There were statistically significant differences in the selection rates of drugswell-equipped,famous experts,service attitude of medical staff,medical technology level and clinical experience among patients with different education levels(χ^(2)=40.040,13.462,17.797,13.382,12.866,all P<0.05).There were no statistically significant differences in the selection rates of drugs well-equipped,famous experts,service attitude of hospital,medical technology level,clinical experience,and service attitude of medical staff(all P>0.05).Conclusion The designated hospitals for occupational diseases and work-related injuries should provide all-round and multi-level medical services,on the basis of fully guaranteeing the medication demand of patients with different occupational diseases,focus on improving the technical level and service attitude of medical personnel,fully leveraging the professional support role of experts and renowned doctors,and meeting the growing medical needs of occupational disease patients,at the same time,the occupational disease and work-related injury management department should play a good supervisory and management role to better serve occupational disease patients.