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目的调查分析安徽省农村居民对基层医疗服务现状的信任程度及其影响因素,为构建分级医疗服务体系和基层医疗卫生资源配置提供参考依据。方法调查问卷通过来自农村、区域分布广泛的本校农村订单定向免费医学生,于2015年利用寒假返乡机会、随机调查其家庭周围的约10户村民,共收集有效问卷739份,分析指标为就诊满意度和对当地基层医疗服务提供者信任程度及其相关因素。结果农村居民感觉到就诊不方便者占54.13%,认为在就诊过程中存在至少1项“不方便”者高达74.70%。其中,“不方便”主要是“候诊时间和候诊秩序(38.29%)”“医生的形象、态度和水平(35.86%)”“收费的合理性和适宜性(33.42%)”等。多因素Logistic回归分析显示,农村居民对医疗机构提供者信任程度不仅与调查对象年龄、性别等生理因素有关,而且与婚姻状况、文化程度、家庭人口数、住房面积大小和对居住环境满意程度有关,提示社会、经济和行为因素间接地影响了农村居民对基层医疗服务现状的信任程度。结论农村居民对基层医疗提供的医疗服务满意度和信任度均不高,造成这种现象不仅与医疗卫生服务的提供能力直接相关,而且与农村社会经济发展、文明生活方式及和谐社会环境等系统工程建设间接地相关。
Objective To investigate and analyze the degree of trust of rural residents in Anhui Province on the status quo of grassroots medical services and its influencing factors so as to provide a reference for constructing a hierarchical medical service system and the allocation of primary health care resources. Methodology Questionnaire Free medical students are directed through rural schools in rural areas and widely distributed in our region. In 2015, we used the return opportunity of winter vacation to randomly survey about 10 villagers around their families. A total of 739 valid questionnaires were collected, Satisfaction and trust in local primary care providers and their related factors. As a result, rural residents felt 54.13% of the patients were inconvenient to visit and 74.70% of them thought they had at least 1 inconvenient during the visit. Among them, “inconvenience ” is mainly “waiting time and the waiting list (38.29%) ” “the doctor’s image, attitude and level (35.86%) ” “the reasonableness and suitability of the fee (33.42% )”Wait. Multivariate Logistic regression analysis showed that the degree of trust of rural residents in the providers of medical institutions was not only related to the physiological factors such as age and sex of the respondents but also to the marital status, educational level, family size, housing area and satisfaction with the living environment , Suggesting that social, economic and behavioral factors have indirectly affected rural residents’ trust in the status quo of grassroots medical services. Conclusion Rural residents are not satisfied with the medical service provided by primary medical care and their trust is low. This phenomenon is not only directly related to the ability to provide health care services, but also to rural social economic development, civilized life style and harmonious social environment Engineering indirectly related.