摘要
目的:基于需方角度对纵向整合模式下的基层医疗卫生机构服务质量进行评价。方法:以北京市大兴区仁和医院和礼贤中心卫生院组成的纵向整合模式为典型案例,利用初级卫生保健质量评价工具PCAT-中文版(Primary Care Assessment Tool)对基层医疗卫生机构就诊病人采取出口调查。定量数据采用描述性统计和多元线性回归分析方法,定性数据采用主题框架分析法。结果:纵向整合模式下,该基层医疗卫生机构PCAT总得分为20.09,"首诊性"为6.59,"连续性"为3.27,"协调性"为4.58,"综合性"为5.62;三个延伸维度"以家庭为中心"为3.07,"面向社区"为1.86,"就医文化"为2.67;PCAT得分在患者就医次数和就医时间长短两个变量具有统计学意义。结论:纵向整合模式下基层医疗卫生机构的首诊性较好,连续性和三个延伸维度仍需进一步加强。未来应借助纵向整合模式的深入开展继续加强基层医疗卫生机构的服务连续性和向下转诊能力,并继续跟踪其效果。
Objective： On the basis of typical cases, the objective of this study is to assess the service quality of primary healthcare institutions under the vertically integrated model from the perspective of demanding side. Methods： The vertical model between Renhe Hospital and Lixian Township Health Center was selected as the case study. Quanti- tative data were collected by exit review using Primary health-Care quality service Assessment Tool （PCAT） -Chinese version from the patients seeking services in Lixian. Quantitative data were analyzed by descriptive statistics and multi- ple linear regression equations while qualitative data were analyzed by thematic framework analysis. Results ： Under the vertical model, the PCAT total score was 20.09. The scores on the first diagnosis, continuity of care, and compre- hensiveness of care and coordination of care were 6.59, 3.27, 4.58 and 5.62 respectively. The scores on the three dimensional extensions, ＂family-centered＂, ＂community-oriented＂, ＂medical culture＂ were 3.07, 1.86 and 2.67 respectively. The difference was significant for the PCAT total score between a number of visits and the length of wait- ing time for services in Lixian. Conclusions： Under the vertical model, primary healthcare institutions did better in the first diagnosis while weaker in continuity and the three dimensional extensions. With the development of the inte- gration, the primary healthcare institutions need to strengthen the continuity and downward referral in the future. Fu- ture researches and follow-up, analysis is needed to track the impact of the vertically integrated model.
出处
《中国卫生政策研究》
CSCD
北大核心
2017年第7期41-46,共6页
Chinese Journal of Health Policy
基金
北京市自然科学基金青年项目(9164036)
关键词
初级卫生保健
纵向整合
基层医疗卫生机构
质量评价
Primary health care
Vertical integration
Primary health institution
Service quality assessment
