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目的:基于对某三甲医院的典型调查,了解门诊就诊患者对分级诊疗的认知和态度。方法:自行设计调查问卷,由4名高年级卫生事业管理专业学生组成调查小组,随机对在该三甲医院心血管内科、风湿免疫科、内分泌科、呼吸内科就诊的门诊患者进行问卷调查,获得有效问卷779份,对资料进行统计描述分析,率的差异性比较采用χ~2检验。结果:(1)患者分级诊疗知晓率为30.8%;年龄、职业、文化程度和医疗保险类型不同,知晓率差异有统计学意义(P<0.05)。(2)基层就医意愿较高,62.3%的患者身体不适时愿意前往基层医疗机构就诊;知晓分级诊疗患者基层就医意愿高于不知晓者。影响患者就医意愿因素中排前三位的是技术、设备和药品。结论:目前患者分级诊疗知晓率不高,宣传力度有待加强,以促进患者对分级诊疗的了解;加强基层医疗机构服务能力建设是推进分级诊疗顺利实施的基础和关键。
Objective: Based on a typical survey of a top three hospital, understand the cognitive and attitude of graded patients in outpatients. Methods: A questionnaire was designed by ourselves. A survey team of 4 senior health management majors formed a randomized questionnaire survey among outpatients in Cardiology, Rheumatology, Endocrinology and Respiratory Medicine of the top three hospitals to obtain effective Questionnaire 779, the statistical analysis of the data, the rate of difference compared using χ ~ 2 test. Results: (1) The awareness rate of patients was 30.8%. There were significant differences in age, occupation, educational level and type of medical insurance (P <0.05). (2) Willingness to seek medical care in grassroots units is higher, 62.3% of patients are willing to go to primary medical institutions when they are not feeling well, and those who know that primary care of patients in grading clinic are higher than those who do not know. The top three factors affecting the patient's willingness to seek medical treatment are technology, equipment and medicines. Conclusion: At present, the awareness rate of grading diagnosis and treatment of patients is not high, and publicity needs to be strengthened so as to promote patients' understanding of grading diagnosis and treatment. Strengthening the service capacity of primary medical institutions is the basis and key to promote the smooth implementation of grading diagnosis and treatment.