中国全科医学2017，Vol.20Issue(1)：40-44,5.DOI:10.3969/j.issn.1007-9572.2017.01.009
公费医疗患者对社区首诊制的接受度及影响因素研究
Acceptance of Gatekeeper System of Patients with State Medicine and Influencing Factors
摘要
Abstract
Objective To investigate the acceptance of gatekeeper system among patients with state medicine and to explore its influence factors. Methods Four community health service centers( CHCs)held by non - medical institutions of higher learning in Wuhan from July to November in 2015 were randomly selected,and 1 200 patients with state medicine and came to CHCs for medical treatment during this period were selected. The Questionnaire Survey of Community Residents designed by research groups was used in this study,and it mainly included patients' basic data,seeking health care behaviors,health condition,intention and cognition of gatekeeper system and evaluation of CHCs. Multivariate Logistic regression analysis were used to explore the influencing factors of the acceptance of gatekeeper system among patients with state medicine. Results A total of 1 162 valid questionnaires were collected,and the effective response rate was 96. 8%. Of these,782(67. 3% )patients with state medicine were familiar with the gatekeeper system and 862(74. 2% )were willing to accept it. There was no significant difference in the acceptance rate of the gatekeeper system among patients with different gender,educational degree,family monthly income and self - rated health status scores(P ﹥ 0. 05);there was significant difference in the acceptance rate of the gatekeeper system among patients with different age,different annual visiting times,and whether patients understand the gatekeeper system,whether patients believed that the diagnosis and treatment level,the medical equipment or drugs supply of CHCs can meet the diagnosis and treatment requirement of common diseases,and whether patients are satisfied with CHCs services(P ﹤ 0. 05). The results of multivariate Logistic regression analysis showed that age,whether patients understand the gatekeeper system,whether patients are satisfied with CHCs services significantly influence the acceptance of the gatekeeper system(P ﹤ 0. 05). Conclusion The acceptance of gatekeeper system among patients with state medicine is relatively high, and it is feasible to implement gatekeeper system from the analyzing perspectives of patients. Age,whether patients understand the relevant policies of the gatekeeper system and whether they are satisfied with the CHCs services are its influencing factors. It is suggested to enhance propaganda work of gatekeeper system,improve patients' understanding of its connotation,and further improve community health services levels at the same time,so as to promote the full implementation of gatekeeper system.关键词
社区首诊制/患者/公费医疗/接受度/影响因素分析Key words
Gatekeeper system/Patients/State medicine/Acceptance/Root cause analysis分类
医药卫生引用本文复制引用
乔岩,卢祖洵,李文祯,宋兴月,陈雅雯,李静,杨婷婷,刘巧艳,王晓君,殷晓旭..公费医疗患者对社区首诊制的接受度及影响因素研究[J].中国全科医学,2017,20(1):40-44,5.基金项目
湖北省分级医疗制度研究 （）
