晚期结直肠癌患者医疗机构选择行为及影响因素研究OACSTPCD

Objective:To investigate the selection of different levels of medical institutions in patients with advanced colorectal cancer and its influencing factors,and provide evidence for the development of medical policies and treatment plans.Methods:This study was based on a national multi-center study.According to the national population and the prevalence of colorectal cancer,277 patients with colorectal cancer were selected by stratified random sampling,and the demographic characteristics and medical experiences were investigated by questionnaire among patients with advanced color-ectal cancer in hospitals in Baotou,Chifeng,Bayannur,and other areas.Epidata 3.1 was used for data entry and double check,and Rv4.1.1 was used for statistical analysis.Results:In all medical stages,the prefecture-level hospitals were the first choice for patients with advanced colorectal cancer.There were 209 patients(76.00％)in the first visit,211 patients(76.73％)in the first diagnosis,182 patients(65.94％)in the first treatment,154 patients(77.78％)in the second treatment,80 patients(79.21％)with recurrence and metastasis,and 149 patients(93.13％)in regular follow-up.The transfer rates at the first treatment,between the first treatment and the second treatment,and after recurrence and metastasis were 38.82％,65.67％and 44.00％,respectively.Bivariable analysis results showed that patients'age,sex,occupation,annual family income,medical insurance,and metastasis at the first diagnosis were not significantly correlated to the choice of medical institutions(P＞0.05).Stepwise screening revealed that factors such as health-related quality of life before initial treatment(P=0.013)and educational level(P=0.002)were significantly correlated to the choice of medical institutions.Multivariable logistic regression analysis results showed that educational level was significantly correlated to the choice of medical institutions(P＜0.001),with fewer people with college education and above choosing provincial hospitals(OR=-7.00,95％CI:-8.89～5.11).Conclusion:Patients with advanced colorectal cancer chose prefecture-level hospitals as their first choice at all stages of medical process,and the education level of colorectal cancer patients was the main factor influencing the choice of medical institutions.Therefore,this factor should be given more consideration when formulating medical policies and treatment plans.