北京市医联体政策背景下慢病患者就医选择影响因素研究

目的:调查医联体建设背景下慢病患者就医选择的特征及状况,为了解患者的就医选择、进一步完善医联体建设提供依据,探讨促进医联体发展的政策建议。方法:对北京市某医联体慢病患者进行抽样调查,样本量为781名患者,使用SPSS21.0对数据进行统计分析。结果:慢病患者的就医选择与人口特征、对医联体的感知、患者满意度三个维度存在显著相关。具体来说,患者性别、年龄、受教育程度等倾向特征,收入、医保情况等使能资源,自感病情,评估健康状况,对医联体的认知和体验等方面均显著地影响患者就医选择。结论:医联体建设能够有效影响患者的就医选择,对引导患者合理就医、推进分级诊疗建设起到了切实有效的作用。但是,医联体建设在加强社区医疗卫生机构药物供给、双向转诊和宣传力度等方面仍需加强。

Study on the influencing factors of the medical treatment choices of chronic disease patients under the background of Beijing integrated health care system

Objective: This study was carried out to investigate the patterns of chronic disease or non-communicable disease (NCD) patients'' choice of medical treatment in the context of integrated health care system, to provide basis for understanding the patients'' medical treatment preferences and further improving the implementation of integrated health care system, and to provide policy suggestions for promoting integrated health care system. Methods: A sample survey was conducted among 781 patients with chronic diseases in a medical consortium in Beijing, and a statistical analysis of data was performed using SPSS21.0 Software. Results: It was found that NCDs patients'' choice of medical treatment significantly correlated with three dimensions of demographic characteristics, perception of integrated health care system and patients'' satisfaction. Specifically, the patients'' propensity characteristic such as gender, age and level of education; enabling resources such as income and medical insurance; self-awareness of the disease, assessment of health status, and cognition and experience of integrated health care system all significantly affect the patient''s choice when it comes to selecting the suitable type of medical treatment. Conclusions: The construction and development of integrated health care system can effectively influence the patient''s choice of medical treatment, and plays an essential role in guiding patients to seek medical treatment reasonably and promoting the construction of graded diagnosis and treatment. However, the construction of integrated health care system should be strengthened in the allocation of health resources such as medicines, two-way referral systems and publicity of community health service.