珠海市高血压糖尿病患者双向转诊意愿及影响因素分析

目的了解高血压、糖尿病患者双向转诊意愿情况,探讨患者双向转诊意愿的影响因素。方法通过自行设计调查问卷,采用多阶段抽样方法进行抽样,收集968名两病患者双向转诊意愿有关资料。采用描述性分析了解患者基本情况、签约状况、患者对制度政策知晓等情况,采用多因素Logistic回归分析探讨两病患者双向转诊意愿的影响因素。结果本次调查愿意双向转诊的两病患者占73.35%,对政策的知晓率为34.40%,两病患者签约高血压、糖尿病分级诊疗管理服务协议签约率为31.71%。影响患者双向转诊意愿的主要因素有认为双向转诊有利于治疗的观念(OR=10.50)、基层配备满足基本需求的药品(OR=4.00)、基层具备合格全科医生(OR=3.50)、近1年到基层就诊经历(OR=3.26)和对基层整体水平满意情况(OR=2.09)。结论珠海市两病患者双向转诊意愿较高,持有双向转诊有利于治疗的观念、认为基层配备药品满足需求、基层具备合格全科医生、近一年有基层就诊经历、对基层整体水平满意是主要影响因素。应加强两病双向转诊政策的宣传力度,完善基层药品配备,多渠道培养合格的全科医生,提升基层整体服务水平,助力两病双向转诊。

Influencing Factors of the Willingness for Two-Way Referral of Patients with Hypertension or Diabetes in Zhuhai

Objective To understand the willingness of patients with hypertension and/or diabetes for two-way referral and analyze influencing factors.Methods A total of 968 patients with hypertension and/or diabetes were selected for a survey with a self-designed questionnaire.Multistage stratified random sampling was applied in collecting data concerning willingness for two-way referral.Results 73.35%of the patients accepted two-way referral.34.30%of the patients knew relative policies.31.71%of the patients had signed the tiered diagnosis and treatment agreements for hypertension and/or diabetes healthcare services.Major influencing factors included whether the patient understands the advantages of two-way referral mechanism(OR=10.50),whether the medicine supply of grass-root institutions can meet basic demands(OR=4.00),whether the grass-root institutions have qualified gene-ral practitioners(OR=3.50),their experiences in grass-root institutions in the recent year(OR=3.26),and whether the patients are satisfied with the overall proficiency of grass-root institutions(OR=2.09).Conclusion Patients with hypertension and/or diabetes in Zhuhai have strong willingness to accept two-way referral.Major influencing factors include whether patients believe in the benefit of two-way referral,whether grass-root institutions have a complete series of drugs,whether grass-root institutions equip with qualified general practitioners,whether they have experiences with grass-root institutions in recent year and whether they are satisfied with grass-root institutions.Policies concerning two-way referral of these two diseases should be further promoted.Grass-root institutions need to optimize medicine supply and cultivate qualified general practitioners in a multi-channel mechanism for service improvement in grass-root institutions and two-way referral promotion among patients with hypertension and/or diabetes.