分级诊疗实施后对医务人员的影响及其认知状况调查

目的:了解分级诊疗制度实施后对试点地区各级医疗机构医务人员的影响,以及医务人员对分级诊疗的认知状况和影响因素。方法:采用多阶段随机抽样方法,对15个试点地区各级医疗机构的435名医务人员进行问卷调查。结果:制度实施后,不同级别医疗机构医务人员在月总收入、绩效工资占比、工作负担和医患关系方面存在差异;各级医疗机构医务人员对分级诊疗的总体认知率达81.4%,其中三级医院依次高于乡镇卫生院、社区卫生服务中心和二级医院;不同科室类别、职称级别、绩效工资占比和薪酬变化的医务人员对分级诊疗认知状况有差异。结论:要进一步发挥医务人员对分级诊疗的关键作用,提升基层服务能力的同时,加大对二级医院的关注,改革薪酬制度,调动医疗机构和医务人员的积极性,促进分级诊疗制度更好地发展。

Cognitive status and impact of tiered medical care system implementation on medical staff

Objective:To understand the impact of hierarchical medical system on the medical staff at all levels of medical institutions in the pilot areas, and their cognitive status and influencing factors for hierarchical medical system, for the purpose of providing scientific reference for improving the hierarchical medical system. Methods:435 of medical staffs were selected with the help of by stratified random sampling from different levels of medical institutions from 15 pilot areas and a questionnaire survey methodology was used in this study to gather views of the medical staffs. Results:It has been revealed that after the system is implemented, there were differences in the total monthly salary, performance pay ratio, workload and the relationship between doctors and patients at different levels of medical institutions. The medical staff at all levels of medical institutions had a high degree of awareness of hierarchical medical system, and the cognition rate was 81.4%. Among them, tertiary hospitals, township hospitals, community health service centers, secondary hospitals; different department categories, job titles, performance pay ratio and salary changes in the medical staff have different cognition of the grading. Conclusions:To further develop the key role of medical staff in the hierarchical medical system, strengthen the attention of secondary hospitals to enhance the service capacity of primary healthcare units at the same time, reform the pay system, mobilize the enthusiasm of medical institutions and medical staff, and promote the development of hierarchical treatment system.