摘要
目的:调查患者对基层医疗机构的信任模式和水平,探索其对基层首诊意愿的影响。方法:采用多阶段抽样和方便抽样,选择山东省青岛市、东营市、枣庄市12区县的38家基层医疗机构,问卷调查当日前去就医的患者和附近居民,共调查676人。结果:64.4%的患者总体上信任基层医疗机构,人际信任(80.3%)高于体系信任(48.6%)。有明确基层首诊意愿的患者比例为60.4%,年轻、高学历人群的基层首诊意愿相对较低。多元线性回归结果表明,体系信任和人际信任可通过总体信任的中介作用影响基层首诊意愿,体系信任的回归系数比人际信任更大。结论:患者对基层医疗机构的人际信任高于体系信任,但影响其总体信任和基层首诊意愿的首要因素是体系信任。当前亟需提升基层医疗水平从而增强患者的体系信任,并借助家庭医生签约服务提质增效的改革契机巩固和突显基层人际信任的比较优势,从而促进分级诊疗目标的实现。
Objectives:To investigate the mode and level of patients trust in primary health institutions,and explore its effect on the willingness of primary first visit.Methods:Multistage sampling and convenience sampling were used,and 38 primary health institutions in 12 districts and counties of Qingdao city,Dongying city and Zaozhuang city in Shandong province of China were selected for a questionnaire survey on the patients who went to hospital on the survey day and nearby residents.A total of 676 people received the survey.Results:64.4%of the patients generally trusted primary health institutions,and interpersonal trust(80.3%)was higher than system trust(48.6%).60.4%of the patients had a clear willingness of primary first visit,while the primary first visit willingness of young and well-educated people was relatively lower.The results of multiple linear regression showed that system trust and interpersonal trust could mediate the willingness of primary first visit through overall trust,while the regression coefficient of system trust was larger than that of interpersonal trust.Conclusions:The patients level of interpersonal trust in primary health institutions is higher than that of system trust,but the primary factor affecting their overall trust and willingness of primary first visit is system trust.Currently,it is an urgent need to improve the level of primary medical services in order to enhance patients system trust in primary health institutions,and consolidate as well as highlight the comparative advantages of interpersonal trust in primary health institutions by taking advantage of the reform of contracted family doctor services aiming for improving both quality and efficiency,so as to promote the realization of the goals of hierarchical diagnosis and treatment.
作者
赵世超
童西洋
张安琪
吴骐均
张奕
王颖
ZHAO Shi-chao;TONG Xi-yang;ZHANG An-qi;WU Qi-jun;ZHANG Yi;WANG Ying(School of Public Administration,Shandong Normal University,Jinan Shandong 250014,China;School of Administration,Shandong University of Traditional Chinese Medicine,Jinan Shandong 250014,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2021年第8期16-20,共5页
Chinese Journal of Health Policy
关键词
患者信任水平
人际信任
体系信任
基层首诊意愿
分级诊疗
Patient s trust level
Interpersonal trust
System trust
Willingness of primary first visit
Hierarchical diagnosis and treatment
