中国农村卫生事业管理2025，Vol.45Issue(12)：882-887,6.DOI:10.19955/j.cnki.1005-5916.2025.12.009
成都市不同级别医院患者分级诊疗的转诊意愿及影响因素的对比分析
A comparative analysis of referral willingness and influencing factors of patients in different-level hospitals within the hierarchical medical system of Chengdu City
摘要
Abstract
Objective To analyze the problems existing in the implementation of the hierarchical medical system from the perspective of patients,and to propose countermeasures based on the identified issues,providing reference suggestions for the implementation of the hierarchical medical system.Methods A total of 743 outpa-tients from two tertiary public hospitals,two secondary public hospitals,and two primary hospitals in Chengdu City were randomly selected for a questionnaire survey.Chi-square tests were used to analyze the single factors influen-cing the referral willingness of patients in different-level medical institutions,and multiple logistic regression analy-sis was used to analyze the multi-factors influencing the referral willingness of patients.Results The proportions of patients who were in favor of referral was 39.2％in tertiary hospitals,68.4％in secondary hospitals,and 73.5％in primary hospitals.Among the influencing factors,referral policies,level of medical care,transporta-tion,and service attitudes all affected the referral willingness of patients.In secondary medical institutions,the differences in environmental facilities(x2=4.7,P=0.08)and medical expense reimbursement(x2=4.6,P=0.08)were not statistically significant,and in primary hospitals,the difference in medical expense reimbursement(x2=1.6,P=0.51)was not statistically significant.The comparisons of the influencing factors of referral will-ingness among patients in different-level medical institutions showed that differences were statistically significant for the remaining factors.Conclusions At present,referral process in the hierarchical medical system has not yet been established for most patients.Enhancing the core competencies of primary health services,implementing the policies for hierarchical medical system,and improving the satisfaction with primary medical services are effective measures to guide patients to form new medical-seeking habits.关键词
分级诊疗/诊疗现状/转诊意愿/影响因素/对比分析/措施建议/局限分析Key words
Hierarchical medical system/Current situation of medical treatment/Willingness to refer/In-fluencing factor/Comparative analysis/Measures and suggestions/Limitation analysis分类
医药卫生引用本文复制引用
XIANG Xiaoli,XIE Yulian,CHEN Xiangbin,WEI Ting,SHI Jia,LIAN Ying,CHEN Yaqin,WANG Yulong..成都市不同级别医院患者分级诊疗的转诊意愿及影响因素的对比分析[J].中国农村卫生事业管理,2025,45(12):882-887,6.基金项目
深圳市"医疗卫生三名工程"项目(SZSM202111010) （SZSM202111010）
深圳市医学重点学科建设经费项目(SZXK048) （SZXK048）
