中国全科医学2017，Vol.20Issue(1)：28-33,6.DOI:10.3969/j.issn.1007-9572.2017.01.007
全科医生对社区首诊制的认可度及影响因素研究
Recognition of General Practitioners on Gatekeeper System and Influencing Factors
摘要
Abstract
Objective To investigate the recognition of general practitioners(GPs)on the gatekeeper system and its influencing factors. Methods Nine hundred and sixteen GPs attending " The training classes for general practitioners service team in Hubei province" from August 2014 to March 2015 were selected. The Questionnaires for Doctors in the Community Health Service Institutions designed by the research group were adopted to investigate the enrolled subjects. The main contents contained the fundamental state of the GPs,their assessment of the ability of community health service institutions( CHIs),business connection between their institutions and the superior hospitals,and their assessment of the gatekeeper system. Multivariate Logistic regression analysis was used to analyze the influencing factors of the recognition of GPs on the gatekeeper system. Results A total of 907 valid questionnaires were collected with an effective response rate of 99. 0% . Of the research results,906 GPs responded to the " evaluation of the gatekeeper system" section,489(54. 0% )believed that the gatekeeper system can ease the problem of " difficulties and high cost in seeking medical care",532(58. 7% )argued that its implementation can play a positive role in leading the community residents to CHIs to seek medical care,755 ( 83. 3% ) GPs deemed that the implementation of the system would affect the source of patients and the income of doctors,848(93. 6% )agreed with the idea that patients transferring to CHIs when they were in a stable condition,and 849(93. 7% )approved of the implementation of the gatekeeper system. The multiple Logistic regression analysis showed that whether GPs believed that the CHIs can undertake the responsibility of " health gatekeeper",whether they have received and treated those patients who transferred from superior hospitals to CHIs,whether they believed that implementation of the gatekeeper system can play a positive role in guiding residents to seek medical care in CHIs,and whether they approved patients transferred to CHIs from the superior hospitals when they were in a stable condition significantly influenced GPs' recognition of gatekeeper system(P ﹤ 0. 05). Conclusion The recognition of the gatekeeper system in community is rather high among GPs. Whether GPs believe that the CHIs can undertake the responsibility of " health gatekeeper",whether GPs receive and treat those patients who transferred from superior hospitals to CHIs,whether GPs believe that implementation of the gatekeeper system can play a positive role in leading residents to seek medical care in CHIs,and whether they approve patients transferred to CHIs from the superior hospitals when they were in a stable condition are its influencing factors. It is suggested to continuously improve the service awareness and ability of GPs,enhance cooperation between CHIs and superior hospitals,so as to promote further implementation of the gatekeeper system.关键词
社区首诊制/全科医生/认可度/影响因素分析Key words
Gatekeeper system/General practitioners/Recognition/Root cause analysis分类
医药卫生引用本文复制引用
胡赛,李文祯,陈雅雯,李静,杨婷婷,宋兴月,卢祖洵..全科医生对社区首诊制的认可度及影响因素研究[J].中国全科医学,2017,20(1):28-33,6.基金项目
湖北省分级医疗制度研究 （）
