中国全科医学2017，Vol.20Issue(3)：347-353,7.DOI:10.3969/j.issn.1007-9572.2017.03.016
四川省城乡患者选择私人诊所的原因调查及影响因素分析
Causes and Influential Factors of Urban and Rural Patients in Sichuan Province Choosing Private Clinics
摘要
Abstract
Objective To observe the causes and influential factors of urban and rural patients in Sichuan province choosing private clinics, and to provide objective basis for the sustainable and healthy development of private clinics in China. Methods From March 2013 to December 2014,stratified sampling method was used to randomly select 10 private clinics and one community health service station in the downtowns in Chengdu,Yibin and Suining respectively;one county( a rural area for short in the following passage)was randomly selected from the dominions of the 3 areas respectively,from which 9 private clinics,one community health service station,one health clinics in towns and townships with relatively good development of medical services,two village clinics and one health clinics in towns and townships with relatively bad development of medical services were selected respectively. Eventually 940 patients who met the inclusion criteria of those health institutions were selected. Self― designed questionnaires were applied to investigate patients' basic information, type of diseases, severity of diseases,and reasons for patients choosing private clinics, community health service station, health clinics in towns and townships;multivariate logistic regression was used to analyze the influencing factors of patients choosing private clinics. Results A total of 940 questionnaires was sent to patients,finally the effective response rate was 97. 8﹪ after excluding 919 incomplete questionnaires. In downtown,patients in private clinics covered 12. 3﹪ ( 113/919 ), patients in community health service station covered 13. 8﹪(127/919);in rural areas,the proportion of patients in private clinics covered 12. 4﹪(114/919), that of patients in community health service station/health clinics in towns and townships/village clinics covered 61. 5﹪( 565/919). In downtown,there was significant difference in the status of patients choosing medical institutions among patients with different occupations and annual family income ( p 〈0. 05 );in rural areas, there was significant difference in the status of patients choosing medical institutions among patients with different genders, age, marital status, educational degrees, occupations and annual family income ( p 〈0. 05 ) . In downtown, there was significant difference in the status of patients choosing medical institutions among patients with different types of diseases(p〈0. 05);in rural areas,there was significant difference in the status of patients choosing medical institutions among patients with different types of diseases and severity of diseases( p〈 0. 05 ) . In downtown, the proportions of patients choosing private clinics due to " high skills" " having acquaintances" and " having trusted doctors" were 47. 8﹪,11. 5﹪ and 39. 8﹪ respectively;in rural areas,the proportion of patients choosing private clinics due to " having trusted doctors" was 45. 6﹪. In downtown,the proportion of patients choosing private clinics due to " high skills" " having acquaintances" and " having trusted doctors" was higher than that of patients in community health service stations. The proportion of patients choosing private clinics due to " fixed units" was lower than that in community health service stations ( p 〈 0. 05 );in rural areas, the proportion of patients choosing private clinics due to" reasonable price" " good equipments" and " fixed units" was higher than that of patients in community health service stations/health clinics in towns and townships/village clinics,the proportion of patients choosing private clinics due to " having trusted doctors" was higher than that of patients in community health service stations/health clinics in towns and townships/village clinics(p〈0. 05). Multivariate logistic regression analysis showed that occupations being the emeritus and retired people〔OR﹦0. 234,95﹪CI(0. 089,0. 615)〕,the unemployed〔OR ﹦0. 300,95﹪CI(0. 118,0. 759)〕,farmers〔OR ﹦0. 273, 95﹪CI(0. 095,0. 788)〕,and chronic diseases〔OR ﹦0. 477,95﹪CI(0. 243,0. 933)〕significantly influence urban patients in choosing private clinics(p〈0. 05);occupation being the workers〔OR﹦0. 383,95﹪CI(0. 170,0. 861)〕,the family annual per―capita income of 10 000 ― 〈30 000 yuan〔OR﹦2. 886,95﹪CI(1. 365,6. 105)〕and 50 000 ― 〈100 000 yuan〔OR ﹦4. 172,95﹪ CI(1. 323,13. 160)〕,and chronic diseases〔OR ﹦ 0. 272,95﹪ CI(0. 140,0. 529)〕significantly influence rural patients in choosing private clinics ( p 〈0. 05 ) . Conclusion The situation of patients choosing private clinics because of " high skill" and " having acquaintance" and " having trusted doctor" is common in downtown, while patients choosing private clinics because of " having trusted doctor" is commonly seen in rural areas. Occupation being retirees,the unemployed and farmers,and chronic diseases are the influencing factors of patients choosing private clinics in urban areas. The occupation being workers,family annual per capita income of 10 000― 〈30 000 yuan and 50 000― 〈100 000 yuan are the influencing factors of patients choosing private clinics in rural areas.关键词
城乡患者/私人诊所/原因/影响因素分析Key words
Urban and rural patients/Private clinics/Causes/Root cause analysis分类
医药卫生引用本文复制引用
曹裴娅,罗会强,吴侃,钱佳慧,刘丹萍..四川省城乡患者选择私人诊所的原因调查及影响因素分析[J].中国全科医学,2017,20(3):347-353,7.基金项目
中央高校基本科研业务费《四川省患者就医流向现状及其对策研究》 （）
