后疫情时代上海市闵行区社区居民分级诊疗认知研究

目的 了解后疫情时代上海市闵行区社区居民关于分级诊疗的认知水平，掌握上海市闵行区现阶段分级诊疗实施现状，为上海市分级诊疗制度的优化提供可靠依据。方法 采用分层随机抽样方法，对符合纳入标准的1060名闵行区居民进行问卷调查，分析分级诊疗制度认知水平及其影响因素。结果 有80.1%（849名）的上海市闵行区居民了解分级诊疗制度，在年龄、户籍、文化程度、医保类型、分级诊疗实施态度、双向转诊态度等不同特征的闵行区社区居民之间，对分级诊疗制度的认知存在差别，差异具有统计学意义（〖XC小五号.EPS;P〗=49.481、107.835、40.583、53.743、21.680、13.542，均P＜0.05）；多因素回归结果显示，非本市户籍（OR=3.098；95%CI, 1.842～5.210）、其他医保类型（OR=1.822；95%CI, 1.154～2.877）、不赞成上海实施分级诊疗（OR=2.416；95%CI, 1.279～4.564）的居民，显著不了解分级诊疗（均P＜0.05）；而文化程度高（OR=0.581、0.506、0.407；95%CI, 0.237～0.897）、60岁以上（OR=0.422；95%CI,0.209～0.852）的居民，显著更了解分级诊疗（均P＜0.05）。上海市闵行区居民获取分级诊疗知识的主要渠道是社区（26.3%）和网络（23.8%）。结论 闵行区居民对分级诊疗制度的认知水平较高，建议相关部门利用“互联网+”与传统模式相结合的宣教新模式，加强全人群分级诊疗制度宣教力度，循序渐进的实现全民健康覆盖。

Cognition of graded diagnosis and treatment among community residents in Minhang District of Shanghai in the post-epidemic era

To understand the community residents’cognitive level of graded diagnosis and treatment in Minhangdistrict of Shanghai in the post － epidemic era，to master the current implementation status of graded diagnosis and treatment inMinhang district of Shanghai，and to provide reliable basis for the optimization of graded diagnosis and treatment system inShanghai. Methods Through stratified random sampling，1 060 residents who met the inclusion criteria were investigated byquestionnaires. The cognitive level and its influencing factors of graded diagnosis and treatment system among residents wereanalyzed. Ｒesults 80. 1% ( 849) residents in Minhang District of Shanghai knew about the graded diagnosis and treatmentsystem. There were significant differences among residents in Minhang District with different characteristics such as age，household registration，education level，type of medical insurance，implementation attitude of graded diagnosis and Bi －directional referral ( χ2 = 49. 481，107. 835，40. 583，53. 743，21. 680，13. 542，all P ＜ 0. 05) . Multiple linear regressionanalysis showed that residents who were not registered in this city ( OＲ = 3. 098; 95% CI: 1. 842 － 5. 210) ，other types ofmedical insurance ( OＲ = 1. 822; 95% CI: 1. 154 － 2. 877) ，and disapprove of graded diagnosis and treatment in Shanghaiobviously ( OＲ = 2. 416; 95% CI: 1. 279 － 4. 564) did not understand the graded diagnosis and treatment system ( all P ＜0. 05) . However，residents with high educational level ( OＲ = 0. 581、0. 506、0. 407; 95% CI: 0. 237 － 0. 897) and over 60years old ( OＲ = 0. 422; 95% CI: 0. 209 － 0. 852) were significantly better aware of the graded diagnosis and treatment systemgraded diagnosis and treatment system for the whole population，so as to gradually realize the nationwide health coverage.( all P ＜ 0. 05) . Community ( 26. 3% ) and network ( 23. 8% ) were the main channels for residents in Minhang District ofShanghai to acquire knowledge of the graded diagnosis and treatment. Conclusion Ｒesidents in Minhang District have a highlevel of awareness of the graded diagnosis and treatment system. It is suggested that the relevant departments should make useof the new education mode of combining the " internet plus" with the traditional mode to strengthen the dissemination of the