摘要
目的了解深圳市坪山新区居民对分级诊疗模式的认知和态度情况,分析影响分级诊疗的因素,给卫生和社会保障行政部门制定分级诊疗相关政策提供理论依据。方法采用多阶段分层随机抽样法,把新区现有两家公立医院,分层随机抽取的6家社康中心为调查点,对就诊的居民随机发放调查问卷,对医院和社康中心管理人员及就诊居民进行访谈。结果被调查的448位居民中68.6%对分级诊疗不了解,居民不同意社康中心首诊和上级医院下转最主要的原因是社康中心设备不如大医院先进。相对于最近社康中心步行时间在5分钟以内居民,步行时间在16~30分钟(OR=0.311,P<0.05)、>30分钟(OR=0.367,P<0.05)居民更倾向于不接受在社康中心首诊。相对于医院就诊居民,一类社康中心(OR=2.344,P<0.05)和二类社康中心(OR=2.733,P<0.05)就诊居民更倾向于同意下转到社康中心。医院和社康中心间信息没有对接,风险共担、利益分配机制尚待建立。结论居民对分级诊疗的认知十分薄弱,最近社康中心距离是影响居民接受社康中心首诊的重要因素;设备相对落后是影响社康中心首诊和下转推行的重要共同因素。
Objective To know the cognition and attitude of Pingshan residents on the hierarchical diagnosis system,to analyze the factors effect and provide theoretical basis for health and social security administration for making relevant policies.Methods Multistage stratified random sampling was adopt,two public hospitals and 6 community centers stratified random sampled were regard as the investigated units,the questionnaires were distributed to the residents. Simultaneously,interview with the administrators in units. Results 68. 8% of the 448 informants were unfamiliar with hierarchical diagnosis system.Residents did not agree with first diagnosis and referring down to the community,the main reason was that there was less sophisticated equipment than pandocheum. Relative to the residents that walk within 5 minutes could reach nearest medical centers,residents that walk in 16 ~ 30 minutes（ OR = 0. 311,P 0. 05） and more than 30 minutes（ OR = 0. 367,P 0. 05）weren＇t inclined to accept the first diagnosis in community. Compared with the residents at hospital,the residents in type Ⅰ（ OR = 2. 344,P 0. 05） and Ⅱ（ OR = 2. 733,P 0. 05） community were more inclined to agree to refer down to the community center. According to the interviews,information was not docked between hospitals and community,risk and profit allocation mechanism was not established. Conclusion The hierarchical diagnosis system are unfamiliar by most residents,the nearest community health center distance is an important factor affecting residents receive community first diagnosis,relatively unsophisticated equipment in communities is common factor of the first treatment and the downward referral to the community.
作者
阚慧
靳娟
陆洋
张秀秀
张瑛
KAN Hui;JIN Juan;LU Yang;ZHANG Xiu-xiu;ZHANG Ying(School of Public Health, Guangdong Pharmaceutical University, Guangzhou , Guangdong , 510310, China;Public Health Bureau of Pingshan New District in Shenzhen)
出处
《中国公共卫生管理》
2018年第1期27-30,共4页
Chinese Journal of Public Health Management
关键词
居民
分级诊疗
态度
影响因素
residents
hierarchical diagnosis system
attitude
factors
