农村居民基层首诊认知偏差影响因素分析

Analysis of Influencing Factors on Cognitive Bias of Rural Residents'First Visit to Primary Care

目的:分析农村居民的就诊认知偏差及其影响因素,为促进基层首诊提供参考依据。方法:采用分层随机抽样对样本市675名农村居民开展问卷调查,利用分层回归模型分析其就诊认知偏差的影响因素。结果:农村居民的疾病认知偏差均值为0.097,基层服务能力认知偏差均值为-0.064;46.22%的就诊认知偏差结构为疾病认知偏差主导型;医院熟人、就诊决策人、风险规避等级及单次门诊价格接受度是疾病认知偏差的影响因素(P<0.05),居住地到乡镇卫生院的距离、就诊决策人及单次门诊价格接受度是基层能力认知偏差的影响因素(P<0.05)。结论:农村居民普遍对疾病严重程度认知过高、对基层医疗机构能力认知过低,导致基层首诊意愿不高;应提高居民的疾病甄别能力,提升基层就诊体验,加强对基层医疗机构和健康知识的宣传,提升农村居民的就诊认知,从而促进基层首诊。

Objective To explore the cognitive bias and influencing factors of rural residents in medical consultation,and to provide reference for the promotion of first visit in primary care.Methods A questionnaire survey was conducted on 675 rural residents in the sample City using stratified random sampling,and the influencing factors of their cognitive bias in medical consultation were analyzed using stratified regression model.Results The mean value of residents'disease cognitive bias was 0.097,and the mean value of primary care capacity cognitive bias was-0.064.46.22%of the structure of visit cognitive bias was of the disease cognitive bias type.Hospital acquaintance,visit decision-maker,risk aversion level and single visit price acceptance were the influencing factors of the disease cognitive bias(P<0.05),and the distance of the place of residence to the township healthcare center,visit decision-maker and single visit price acceptance were the influencing factors of the primary care capacity cognitive bias(P<0.05).Conclusion Rural residents generally have too high a perception of disease severity and too low a perception of primary care capacity,which leads to a low willingness to make a first visit to primary care.It is necessary to improve residents'ability to identify diseases,enhance their experience of primary care,strengthen the publicity of primary healthcare institutions and health knowledge,and enhance the rural residents'perception of medical consultation,so as to promote the first visit to primary care.