中国全科医学2017，Vol.20Issue(31)：3880-3885,6.DOI:10.3969/j.issn.1007-9572.2017.31.010
山东省试点城市城乡居民分级诊疗制度认知、态度及行为研究
Cognition, Attitude and Behavior of Urban and Rural Residents to the Hierarchical Medical System in Pilot Cities of Shandong Province
摘要
Abstract
Objective To observe the cognition,attitude and behavior of urban and rural residents to the hierarchical medical system in three pilot cities of Shandong Province.Methods Using multistage stratified random sampling method,three districts (counties) were selected from each of three cities (Weifang City,Dongying City and Weihai City),and two urban communities and two administrative villages were selected randomly from each district (county) according to the level of economic development.45 households were selected randomly from each urban community and 30 households were selected randomly from each administrative village.A total of 1 350 households were selected.A self-designed questionnaire was used in the survey from January to August in 2016.The questionnaire mainly included the baseline information of residents,the cognition of the relevant knowledge about hierarchical medical system,the attitudes towards the implementation of hierarchical medical system,and the medical behavior based on hierarchical medical system.A total of 1 350 questionnaires were distributed and 1 306 valid questionnaires were collected.The effective recovery rate was 96.74％.Results Among 3 096 residents,1 215 (39.24 ％) residents knew the hierarchical medical system.There were statistically significant differences in the awareness rate of the hierarchical medical system among different residents types,sex,age,educational level,family income last year and family medical expenses last year (P ＜ 0.05).After a brief understanding of the connotation and function of the hierarchical medical system,1 877 (60.63％) residents thought that hierarchical medical system could reduce the medical expenses.1 392 (44.96％) residents thought that the hierarchical medical system did not affect the curative effect,and 2 140 (69.12％) residents agreed the implementation of the hierarchical medical system.Whether the hierarchical medical system could reduce medical expenses and influence the curative effect and whether the residents agreed the implementation of the hierarchical medical system,there were statistically significant differences in the attitudes of residents among different residents types,sex,age,family income last year and family medical expenses last year (P ＜ 0.05).Among 2 140 residents who agreed the implementation of hierarchical medical system,714 (33.36％) residents did not choose the primary medical institutions as their first visits to the doctor for the common diseases,frequently-occurring diseases and chronic diseases.Among these residents,693 (97.06％) residents were urban residents and the reason why they did not choose the primary medical institutions as their first visits to the doctor was that 472 (68.11％) residents had no confidence in the medical level of the medical staff in primary medical institutions.21 (2.94％) residents were rural residents and 16 (76.19％) residents considered that the primary medical institutions did not have the medicines they need.Whether to choose the primary medical institutions to continue the treatment of the diseases that were controlled in the higher-level hospital or at the rehabilitation stage,685 (32.01％) residents gave negative answers.Among these residents,574 (83.80％) residents were urban residents and the reason was that 342 (59.58％) residents had no confidence in the medical level of the medical staff in the primary medical institutions.111 (16.20％) residents were rural residents and 72 (64.86％) residents considered that the primary medical institutions did not have the medicines they need.Conclusion The awareness rate of the hierarchical medical system of urban and rural residents is not high in pilot cities of Shandong province while urban and rural residents have different attitudes towards the hierarchical medical system.The primary medical level and whether there are drugs or not in the primary medical institutions are key factors that affect the choice of healthcare services among urban and rural residents.It is recommended to accurately grasp publicity channels and contact points of the hierarchical medical system and differentiate the supporting systems of the hierarchical medical system in related fields in order to change the medical habits of urban and rural residents through the different operation modes of medical consortium.关键词
分级诊疗/农村人口/市区人口/认知/态度Key words
Hierarchical medical system/Rural population/Urban population/Cognition/Attitude分类
医药卫生引用本文复制引用
娄鹏宇,张黎..山东省试点城市城乡居民分级诊疗制度认知、态度及行为研究[J].中国全科医学,2017,20(31):3880-3885,6.基金项目
2015年山东省医学卫生科技发展计划项目(2015WS0061) （2015WS0061）
