城镇职工医保患者对社区首诊制的接受度及影响因素研究
发布时间：2018-08-03 09:35
【摘要】：目的了解城镇职工医保患者对社区首诊制的接受度,并探讨其影响因素。方法于2015年7—9月,采用随机抽样法,在南京市随机抽取2个区,每个区随机抽取2个街道,每个街道随机抽取1家社区卫生服务中心(CHCs),选取研究期间至该4家CHCs门诊就诊的城镇职工医保患者1 100例。采用自行设计的《社区居民问卷调查表》对纳入患者进行调查,主要内容包括居民的基本情况、健康状况、就诊行为、对CHCs的评价、对社区首诊制的意愿和认知。采用多因素Logistic回归分析探讨城镇职工医保患者对社区首诊制接受度的影响因素。结果共回收有效问卷1 058份,问卷有效回收率为96.2%。其中501例(47.4%)城镇职工医保患者愿意接受社区首诊制,669例(63.2%)对CHCs的报销比例感到满意,429例(40.5%)了解社区首诊制相关政策,666例(62.9%)认为转诊可能延误病情。不同性别、婚姻状况、家庭人均月收入、自评健康状况得分,以及家中是否有医疗工作者、是否因强制规定至CHCs就诊、是否在意医疗费用、是否有转诊经历患者的社区首诊制接受率比较,差异无统计学意义(P0.05);不同年龄、文化程度、职业类型、年就诊次数,以及是否患慢性病、是否认为CHCs就诊费用较低、是否认为CHCs诊疗水平能够满足居民常见病诊治、是否认为CHCs医疗设备能够满足居民常见病诊治、是否认为CHCs药品配备能够满足居民常见病诊治、是否对CHCs的报销比例感到满意、是否了解社区首诊制相关政策、是否认为转诊可能延误病情患者的社区首诊制接受率比较,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,年就诊次数≤3次、是否认为CHCs就诊费用较低、是否认为CHCs药品配备能够满足居民常见病诊治、是否对CHCs的报销比例感到满意、是否了解社区首诊制相关政策、是否认为转诊可能延误病情是城镇职工医保患者对社区首诊制接受度的影响因素(P0.05)。结论城镇职工医保患者对社区首诊制的接受度较高,从患者角度分析社区首诊制在我国的实施可行性较高。年就诊次数≤3次、不认为CHCs就诊费用较低、不认为CHCs药品配备能够满足居民常见病诊治、对CHCs的报销比例不满意、不了解社区首诊制相关政策、认为转诊可能延误病情不利于患者接受社区首诊制。建议加大宣传力度,加深患者对制度的理解,同时提高社区卫生服务中心报销比例和转诊效率,以促进社区首诊制的进一步实施。
[Abstract]:Objective to understand the acceptance of community first-visit system in urban health insurance patients and to explore its influencing factors. Methods from July to September 2015, two districts were randomly sampled in Nanjing, and 2 streets were randomly selected from each district. One community health service center (CHCs),) was randomly selected from 1 100 urban health insurance patients from 4 CHCs outpatient clinics in each street. A self-designed questionnaire for community residents was used to investigate the patients involved. The main contents included residents' basic condition, health status, visit behavior, evaluation of CHCs, willingness and cognition of community first visit system. Multivariate Logistic regression analysis was used to explore the factors influencing the acceptance of community first visit system in urban workers. Results 1 058 valid questionnaires were collected and the effective recovery rate was 96. 2%. Among them, 501 (47.4%) urban workers were willing to accept the community first consultation system. 669 (63.2%) were satisfied with the reimbursement rate of CHCs. 666 (62.9%) were satisfied with the related policies of community first consultation system, and 666 (62.9%) thought that the referral might delay the illness. Gender, marital status, monthly income per family, self-rated health status scores, and whether there are medical workers in the family, whether they are required to visit the CHCs, and whether they care about the cost of medical care. There was no significant difference in the acceptance rate of the first visit in the community (P0.05); different age, education level, occupation type, number of visits per year, chronic disease, whether the cost of CHCs was lower, whether the patients had a referral experience or not, the difference was not statistically significant (P0.05), and there was no significant difference between the two groups (P0.05). Do they think that the level of CHCs diagnosis and treatment can meet the common diseases of residents, whether they think that CHCs medical equipment can satisfy the diagnosis and treatment of common diseases of residents, whether they think that the provision of CHCs drugs can satisfy the diagnosis and treatment of common diseases of residents, and whether they are satisfied with the reimbursement ratio of CHCs; Whether to understand the community first-visit system related policies, whether the referral may delay the disease patients in the community first visit acceptance rate, the difference was statistically significant (P0.05). The results of multivariate Logistic regression analysis showed that if the number of visits was less than 3 times a year, whether the cost of CHCs was lower, whether the drug equipment of CHCs could satisfy the diagnosis and treatment of common diseases of residents, and whether it was satisfied with the proportion of reimbursement for CHCs. Whether to understand the community first-visit system related policies, whether the referral may delay the illness is the urban workers health insurance patients' acceptance of the community first-visit system influencing factors (P0.05). Conclusion the community first diagnosis system is accepted by urban workers and workers, and it is feasible to analyze the community first diagnosis system in our country from the point of view of patients. The number of visits 鈮，
本文编号：2161333
[Abstract]:Objective to understand the acceptance of community first-visit system in urban health insurance patients and to explore its influencing factors. Methods from July to September 2015, two districts were randomly sampled in Nanjing, and 2 streets were randomly selected from each district. One community health service center (CHCs),) was randomly selected from 1 100 urban health insurance patients from 4 CHCs outpatient clinics in each street. A self-designed questionnaire for community residents was used to investigate the patients involved. The main contents included residents' basic condition, health status, visit behavior, evaluation of CHCs, willingness and cognition of community first visit system. Multivariate Logistic regression analysis was used to explore the factors influencing the acceptance of community first visit system in urban workers. Results 1 058 valid questionnaires were collected and the effective recovery rate was 96. 2%. Among them, 501 (47.4%) urban workers were willing to accept the community first consultation system. 669 (63.2%) were satisfied with the reimbursement rate of CHCs. 666 (62.9%) were satisfied with the related policies of community first consultation system, and 666 (62.9%) thought that the referral might delay the illness. Gender, marital status, monthly income per family, self-rated health status scores, and whether there are medical workers in the family, whether they are required to visit the CHCs, and whether they care about the cost of medical care. There was no significant difference in the acceptance rate of the first visit in the community (P0.05); different age, education level, occupation type, number of visits per year, chronic disease, whether the cost of CHCs was lower, whether the patients had a referral experience or not, the difference was not statistically significant (P0.05), and there was no significant difference between the two groups (P0.05). Do they think that the level of CHCs diagnosis and treatment can meet the common diseases of residents, whether they think that CHCs medical equipment can satisfy the diagnosis and treatment of common diseases of residents, whether they think that the provision of CHCs drugs can satisfy the diagnosis and treatment of common diseases of residents, and whether they are satisfied with the reimbursement ratio of CHCs; Whether to understand the community first-visit system related policies, whether the referral may delay the disease patients in the community first visit acceptance rate, the difference was statistically significant (P0.05). The results of multivariate Logistic regression analysis showed that if the number of visits was less than 3 times a year, whether the cost of CHCs was lower, whether the drug equipment of CHCs could satisfy the diagnosis and treatment of common diseases of residents, and whether it was satisfied with the proportion of reimbursement for CHCs. Whether to understand the community first-visit system related policies, whether the referral may delay the illness is the urban workers health insurance patients' acceptance of the community first-visit system influencing factors (P0.05). Conclusion the community first diagnosis system is accepted by urban workers and workers, and it is feasible to analyze the community first diagnosis system in our country from the point of view of patients. The number of visits 鈮，
本文编号：2161333
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