Journal of Shandong University (Health Sciences) ›› 2017, Vol. 55 ›› Issue (12): 82-87.doi: 10.6040/j.issn.1671-7554.0.2017.270

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Residents’ choices of medical treatment institutions based on hierarchical diagnosis and treatment system in Xuzhou City

MIAO Chunxia1, LI Hanhan1, ZHUO Lang1, WANG Wenhai2, JIANG Jinxing1, ZHENG Juan1, HUANG Wenhao1, ZHAO Shihong1   

  1. 1. Research Centre of Health Policy and Health Management, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China;
    2. Health Emergency Response Office, Xuzhou Health and Family Planning Commission, Xuzhou 221004, Jiangsu, China
  • Online:2017-12-20 Published:2022-09-27

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Abstract: Objective To investigate residents’ choice of medical treatment institutions and the influencing factors in Xuzhou City, and to provide scientific and feasible suggestions for the formation of good medical order and the improvement of medical treatment. Methods People who had no cognitive impairment and over 18 years old were selected by using stratified random sampling method in Xuzhou City. A total of 1 550 questionnaires were distributed and 1 473 were recovered. Results Among the 1 473 residents, 1 218(82.69%)fell ill, 930(76.35%)of whom chose medical treatment, 545(58.60%)of whom chose primary medical institutions and the other 385(41.40%)chose general hospitals. Binary Logistic analysis showed that the influencing factors of health care service choice consist of average family monthly income, medical expense, distance to medical institutions, whether knowing the hierarchical medical diagnosis and treatment system. Conclusion The percentage of choosing first treatment in the community is 58.60%. Residents preferred to primary medical institutions, who had lower average monthly income and lower medical costs, who was closer to primary medical institutions and was longer to the general hospitals, and who known the hierarchical medical diagnosis and treatment system.

Key words: Hierarchical diagnosis and treatment system, Choice of medical treatment, Medical treatment institutions, First treatment in the community, Influencing factors

CLC Number: 

  • R197
[1] 匡莉, LiLi. 全科医疗特征功能视角下分级诊疗的定义及制度层次[J]. 中国卫生政策研究, 2016, 9(1): 19-26. KUANG Li, LiLi. The definition of tiered health care systems and institutional levels from perspective of general practice attributes in China[J]. Chinese Journal of Health Policy, 2016, 9(1): 19-26.
[2] 王虎峰, 元瑾. 对建立分级诊疗制度相关问题的探讨[J]. 中国医疗管理科学, 2015, 5(1): 11-15. WANG Hufeng, YUAN Jin. Probe of relevant issues concerning the establishment of tiered diagnosis and medical treatment system[J]. China Medical Administration Sciences, 2015, 5(1): 11-15.
[3] 中共中央国务院. 关于推进分级诊疗制度建设的指导意见[EB/OL].(2015-09-11)[2017-07-10]. http://www.gov.cn/zhengce/content/2015-09/11/content_10158.htm.
[4] 马小磊, 杨云滨, 肖俊辉, 等. 我国社区医疗机构与医院互动困境及对策探讨[J]. 卫生软科学, 2017, 3(11): 7-10. MA Xiaolei, YANG Yunbin, XIAO Junhui, et al. Discussion on dilemma and countermeasure of mutual-action between community medical institutions and hospitals in China[J]. Soft Science of Health, 2017, 3(11): 7-10.
[5] 沈蔷, 白永涛, 赵海, 等. 社区卫生服务机构的专科建设[J]. 中国全科医学, 2016, 19(25): 3074-3077. SHEN Qiang, BAI Yongtao, ZHAO Hai, et al. Specialized department construction of community health service institutions[J]. Chinese General Practice, 2016, 19(25): 3074-3077.
[6] 吕键. 论深化医改进程中分级诊疗体系的完善[J]. 中国医院管理, 2014, 34(6): 1-3. L(¨overU)Jian. Improvement of hierarchical diagnosis and treatment system under deepening medical and health reform[J]. Chinese Hospital Management, 2014, 34(6): 1-3.
[7] Goldfield O, Gnani S, Majeed A. Profiling performance in primary care in the United States[J]. BMJ, 2003, 326(7392): 744-747.
[8] 魏敏, 肖锦铖. 患者就医选择的影响因素及对策分析[J]. 中国卫生事业管理, 2014, 31(4): 259-261. WEI Min, XIAO Jincheng. Study on influencing factors and countermeasures analyses of choosing a different medical institutions by patients[J]. Chinese Health Service Management, 2014, 31(4): 259-261.
[9] 吴婷, 宋静媛, 朱昌蕙. 成都市居民就医行为的调查与医疗服务建议[J]. 现代预防医学, 2010, 37(5): 856-858. WU Ting, SONG Jingyuan, ZHU Changhui. The survey and suggestion of health service based on healthcare-seeking behavior among the residents in Chengdu city[J]. Modern Preventive Medicine, 2010, 37(5): 856-858.
[10] 李习平, 史华英. 新医改背景下患者就医影响因素调查研究[J]. 现代医院管理, 2016,14(1): 26-28. LI Xiping, SHI Huaying. Investigation and study of influencing factors on patients’ decision for medical treatment in new medical reform[J]. Modern Hospital Management, 2016, 14(1): 26-28.
[11] 肖淑娴, 钟迪浩, 陈志强, 等. 广州地区患者就诊选择的影响因素分析[J]. 中国医疗管理科学, 2016, 6(5): 41-45. XIAO Shuxian, ZHONG Dihao, CHEN Zhiqiang, et al. Analysis of influence factors to patients’ selection of medical treatment by taking example of Guangzhou area[J]. China Medical Administration Sciences, 2016, 6(5): 41-45.
[12] 孙春梅, 张宁, 田瑾. 上海市某社区居民就医行为调查[J]. 上海医药, 2014, 35(18): 21-23. SUN Chunmei, ZHANG Ning, TIAN Jin. Survey of the health seeking behavior of the residents of a community in Shanghai[J]. Shanghai Medical & Pharmaceutical Journal, 2014, 35(18): 21-23.
[13] 韩虎, 徐凌忠, 王兴洲, 等. 山东省农村居民就医行为调查[J]. 社区医学杂志, 2011, 9(6): 43-44.
[14] 徐州市卫生和计划生育委员会. 关于推进分级诊疗制度建设的实施方案[EB/OL].(2015-11-02)[2017-03-27]. http://ws.xz.gov.cn/wsj/xzswshjhsywyh/2015-1102/028003_b4e3c3e4-ea04-4643-958f-ee349952c250.htm.
[15] 付强. 促进分级诊疗模式建立的策略选择[J]. 中国卫生经济, 2015,34(2): 28-31. FU Qiang. Strategic choice for promoting hierarchical treatment model[J]. Chinese Health Economics, 2015, 34(2): 28-31.
[16] 朱小凤, 李道丕, 刘中华, 等. 分级诊疗制度下患者就医意向的影响因素研究[J]. 中国医院, 2017, 21(1): 34-37. ZHU Xiaofeng, LI Daopi, LIU Zhonghua, et al. Analysis on factors affecting the patients medical intention under hierarchical diagnosis system[J]. Chinese Hospitals, 2017, 21(1): 34-37.
[17] 李江平, 王云, 张翻弟. 宁夏回族自治区西吉县农业人群自我医疗现况及影响因素分析[J]. 中国公共卫生, 2017, 33(2): 274-279. LI Jiangping, WANG Yun, ZHANG Fandi. Prevalence and associated factors of self-medication among rural residents in Xiji county of Ningxia Hui Autonomous Region[J]. Chinese Journal of Public Health, 2017, 33(2): 274-279.
[18] 国家卫生计生委统计信息中心. 2013第五次国家卫生服务调查分析报告[M]. 北京: 中国协和医科大学出版社, 2016.
[19] 程金米. 陕西商洛新声村空巢老人生活境况调研[J]. 新西部, 2017,(3): 19-20.
[20] 刘宁, 陈敏. 基于分级诊疗视角的就医行为分析及相关策略研究[J]. 中国医院管理, 2016, 36(422): 19-21. LIU Ning, CHEN Min. Healthcare seeking behavior analysis and strategy research based on hierarchical diagnosis and treatment[J]. Chinese Hospital Management, 2016, 36(422): 19-21.
[21] 楚蓓, 王伟, 兰迎春. 城乡居民就医行为多元影响因素分析[J]. 医学与哲学, 2013, 34(19): 45-47. CHU Bei, WANG Wei, LAN Yingchun. Analysis of multiple factors influencing urban and rural residents’ medical behaviors[J]. Medicine & Philosophy, 2013, 34(19): 45-47.
[22] 陈饶, 杜旭东, 杨展, 等. 成都市门诊就诊患者就医选择及影响因素分析[J]. 现代预防医学, 2016, 43(22): 4217-4220. CHEN Rao, DU Xudong, YANG Zhan, et al. Analysis of choice of healthcare services and the influencing factors among outpatients in Chengdu city[J]. 2016, 43(22): 4217-4220.
[23] Gagné S, Vasiliadis HM, Préville M. Gender differences in general and specialty outpatient mental health service use for depression[J]. BMC Psychiatry, 2014, 14: 135. doi: 10.1186/1471-244X-14-135.
[24] 姜亦洋, 杨佳. 基于就医选择影响因素优化的分级诊疗实现路径[J]. 中国医院, 2015, 19(12): 15-17. JIANG Yiyang, YANG Jia. Route of achieving hierarchical medical system by optimizing the elements of affecting the choice of medical service[J]. Chinese Hospitals, 2015, 19(12): 15-17.
[25] 励丽, 姚爱京, 俞旭霞, 等. 三级医院推进分级诊疗的探索与实践[J]. 中国慢性病预防与控制, 2016, 24(11): 868-870. LI Li, YAO Aijing, YU Xuxia, et al. Exploration and practice of hierarchical diagnosis and treatment system in tertiary care hospital[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2016, 24(11): 868-870.
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