基层医务人员对分级诊疗制度实施的认知调查--以武汉市为例

目的探讨基层医务人员对分级诊疗制度的认知、态度及影响分级诊疗制度实施的因素,为进一步完善分级诊疗制度的实施提供科学依据。方法采用自行问卷设计,整群抽样,对武汉市武昌区和青山区共1 858名医务人员进行问卷调查。结果 91.8%的基层医务人员认为实施分级诊疗是必要的;53.3%的医务人员认为分级诊疗制度实施效果一般;48.3%的医务人员并无转诊经历。接诊下转病人能力方面,民营办医疗机构>企业办医疗机构>政府办医疗机构,差异具有统计学意义(P<0.05);转诊病人经历方面,企业办医疗机构>民营办医疗机构>政府办医疗机构,差异具有统计学意义(P<0.05)。结论分级诊疗制度在落实方面仍然存在一些困难,提高基层医疗机构的服务能力、政府加强政策引导、组建紧密型医联体是深入推进分级诊疗制度实施的重要途径。

A cognition survey of grassroots medical staff on the implementation of hierarchical diagnosis and treatment system:A case study of Wuhan

Objective To explore the cognition and attitude of the grass-roots medical staff to the hierarchical diagnosis and treatment system and the factors influencing its implementation, so as to provide a scientific basis for further improving the implementation. Methods Totally 1858 medical and nursing staff in Wuchang District and Qingshan District of Wuhan city were surveyed by using self-designed questionnaire with cluster sampling method. Results The survey showed that 91.8% of the primary medical and nursing staff thought it necessary to carry out hierarchical diagnosis and treatment, 53.3% thought that the implementation of the system was not effective, and 48.3% had no referral experience. In terms of the ability to treat referred patients, institutions ranking in descending order were privately run medical institutions, enterprise-run medical institutions and government-run medical institutions;the difference was statistically significant(P<0.05). In terms of the experience in referring patients, institutions ranking in descending order were enterprise-run medical institutions, privately run medical institutions and government-run medical institutions;the difference was statistically significant(P<0.05). Conclusions There are still some difficulties in the implementation of the hierarchical diagnosis and treatment system. The important ways to further promote the implementation are to improve the service capacity of primary medical institutions, to strengthen policy guidance of the government and to organize a tight medical association.