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目的:研究湖南省农村居民就诊意向和新医改政策推行前后的就诊流向变化,分析其存在的问题其原因,为完善农村卫生资源配置、加强就诊行为引导提供决策依据。方法:采用多阶段分层整群随机抽样的方法,用自行设计的调查表进行资料收集,对农村居民2012年的就诊意向和2008-2012年就诊流向的变动趋势进行描述性统计分析。结果:2012年湖南省农村居民就诊意向以选择基层卫生服务机构为主。农村居民就诊流向发生了较大变化,流向县及以上医疗机构的农村居民逐渐增多。结论:湖南省农村居民就诊意向与流向之间存在一定的差异,这与卫生服务供方发展不平衡、医疗保障制度等诸多因素有关系。
OBJECTIVE: To study the changes in the orientation of visits to rural residents in Hunan Province before and after the implementation of the new medical reform policy and to analyze the reasons for the existing problems in order to provide a basis for decision-making on improving the allocation of rural health resources and stepping up treatment behavior guidance. Methods: A multi-stage stratified cluster random sampling method was used to collect the data with a self-designed questionnaire. Descriptive statistical analysis was made on the rural residents’ intention to visit in 2012 and the changing trend of the flow from 2008 to 2012. Results: In 2012, rural residents in Hunan Province preferred to choose primary health care services. There has been a big change in the flow of rural residents to hospitals and the number of rural residents who flow to medical institutions at or above the county level has been gradually increasing. Conclusion: There is a certain difference between the intention and direction of rural residents in Hunan Province, which is related to the unbalanced development of health service providers and the medical insurance system.