成都市性病患者就诊流向分析

The study on medical care seeking behavior among STDs patients in Chengdu

目的 研究法定报告性病患者患病后的就诊行为及其影响因素。 方法 对成都市各级各类医疗机构的 2 2 1例法定报告性病患者 ,分别患有淋病、梅毒、非淋菌性尿道炎、生殖器疱疹和尖锐湿疣等 5种法定报告性病中的 1种或几种进行匿名问卷调查。 结果 不同病种的病人患病后选择到医疗机构就诊的比例不同 ;除淋病外 ,各病种患者的平均就诊次数 >2次 ;病人选择不同类型医疗机构的主要原因不同 ,首次就诊倾向于到省级综合医院就诊 ;转换就诊机构主要是在公立医疗机构之间转换以及从私立医疗机构转到公立医疗机构 ,年龄、文化程度、病种、病程长短和治疗效果等因素会影响病人转换就诊机构的行为 ,向公立医疗机构的转换主要通过非正规途径影响 ,而向私立医疗机构的转换受正规途径 (媒体宣传 )的影响较大。 结论 不同患者的就诊行为不同 ,受人口学因素、患病状况、医疗服务提供状况和媒体宣传的影响 ,建议规范对性病医疗机构的宣传 ,通过引入竞争机制使各类医疗机构约束诊疗行为。

Objective Study medical care seeking behaviors among patients with hotifiable STDs and their influencing factors Method Interview with 221 cases with 5 types of hotifiable STDs reported from different hospital in chengdu including gonorrhea,syphilis,NGU,genital herpes and condyloma acuminatum Result The proportion of visiting clinics for the patients with these 5 diseases is different,the average visits are more than twice except for gonorrhea,and the patients selected different medical institutions for different reasons Patients preferred visiting provincial general hospitals for the first time;but they might transfer from one pubic hospital to another,or from one private hospital to a pubic one,and such behaviors were associated with age,gender,education background,diagnosis,sickness duration and therapeatic effect Any transfer between public hospitals way effected by informal channel while transfer to private hospitals was largely related with formal channel such as mass media Conclusion The medical care seeking behavior depends on demographic factors,disease,health serice supply and advertisement of mass media It is suggested that the advertisment for STDs care providers be regulated and competition mechanism be introduced to regulate the providers,which would be useful for the control of irrational cost in STD treatiment