基于分级诊疗制度的徐州市居民就医机构选择

doi:10.6040/j.issn.1671-7554.0.2017.270

摘要/Abstract

摘要： 目的了解徐州市居民就医机构选择及影响因素,为形成良好就医秩序,改善患者就医选择提供科学可行的建议。方法采用分层随机抽样的方法,抽取徐州市无认知障碍的成年居民1 550名并发放问卷,有效回收1 473份。结果 1 473名居民中有1 218名患病(82.69%);其中,未就医288名(23.65%),就医930名(76.35%);就医患者中选择基层医疗机构545名(58.60%),综合医院385名(41.40%)。二分类Logistic回归分析表明,影响徐州市居民就医选择的因素包括:家庭月均收入、医疗费用、与基层医疗机构的距离、与二三级医疗机构的距离、是否知晓分级诊疗制度。结论徐州市居民基层首诊率为58.60%,家庭月均收入低、医疗费用低、与基层医疗机构近、与二三级医疗机构的距离远、知晓分级诊疗制度的居民,选择基层医疗机构的首诊比例高。

关键词: 分级诊疗, 就医选择, 就医机构, 基层首诊, 影响因素

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

中图分类号:

R197

苗春霞,李寒寒,卓朗,王问海,姜金星,郑娟,黄文昊,赵世鸿. 基于分级诊疗制度的徐州市居民就医机构选择[J]. 山东大学学报 (医学版), 2017, 55(12): 82-87.

MIAO Chunxia, LI Hanhan, ZHUO Lang, WANG Wenhai, JIANG Jinxing, ZHENG Juan, HUANG Wenhao, ZHAO Shihong. Residents’ choices of medical treatment institutions based on hierarchical diagnosis and treatment system in Xuzhou City[J]. Journal of Shandong University (Health Sciences), 2017, 55(12): 82-87.

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