中国卫生事业管理2026，Vol.43Issue(7)：750-754,5.
县域医共体内患者持续就医行为双因素模型构建及验证研究
Study on the Construction and Validation of A Two-Factor Model of Continuous Medical Seeking Behaviors of Pa-tients in A County Medical Community
摘要
Abstract
Objective To construct and validate a two-factor model of patients'continuous medical seeking behavior under the county-level hierarchical diagnosis and treatment system,and provide localized empirical evidence for optimizing primary medical services and promoting an orderly medical treatment pattern.Methods Based on customer satisfaction theory,a two-factor model of hierarchical collaboration-oriented technical competence and humanistic experience was constructed.A questionnaire was de-veloped,and convenient sampling was adopted to investigate patients in the county medical community.Structural equation model-ing(SEM)was used to conduct an empirical test with 349 valid questionnaires.Results Technical competence and humanistic ex-perience indirectly influenced the continuous medical seeking behavior through satisfaction and doctor-patient trust,with stand-ardized path βvalues ranging from 0.250 to 0.410 and 0.330 to 0.570,respectively.The smoothness of hierarchical referral had a significant effect on satisfaction(β=0.380),and hospital identity had the strongest directly driving effect on continuous medical seeking behavior(β=0.409),which was the core influencing factor.The model fit indices were satisfactory(χ2/df=2.454,GFI,AGFI,NFI,CFIall＞0.9,RMSEA=0.045).The scores of observed variables ranged from 3.52 to 4.38,indicating rea-sonable data distribution.Conclusion The quality of hierarchical linkage and local hospital identity are key to stabilizing patients'continuous medical seeking behavior in county areas.Taking technical collaboration as the foundation and emotional connection as the core,county medical communities can achieve the goal of treating serious illnesses within the county.关键词
县域医共体/分级诊疗/患者持续就医行为/分级衔接/双因素模型/医院认同感Key words
county medical community/hierarchical diagnosis and treatment/patients'continuous medical seeking behav-ior/hierarchical linkage/two-factor model/hospital identity分类
医药卫生引用本文复制引用
邓川芬,王彬,石景芬,王大超,杨竹,任玉平..县域医共体内患者持续就医行为双因素模型构建及验证研究[J].中国卫生事业管理,2026,43(7):750-754,5.基金项目
四川省科技计划资助项目"基于互联网+医联体的急性上消化道出血疾病防治融合服务体系的构建及应用研究"(2023JDR0252) （2023JDR0252）
国家卫生健康委医院管理研究所国家重点研发计划"老年多病共存连续服务模式构建及区域示范应用"(2023YFC3605005) （2023YFC3605005）
四川省医院协会医务管理分会资助项目"基于县域医共体背景下FOCUS-PDCA循环模式提升基层预约诊疗率的研究"(SCYW25-25) （SCYW25-25）
川北医学院四川省基层卫生事业发展研究中心重点项目"四川省区县级医院学科发展现状及影响因素分析"(SWFZ24-Z-08) （SWFZ24-Z-08）
