Status of Dual-Referral and Influencing Factors for Down-Referral on Medical Staff
Objective To investigate the knowledge,attitude,practice(KAP)of medical staff on dural referral in Anyang,meanwhile investigate and analyze the influencing factors of medical staff's preference for down-referral in tertiary hospital.To provide scientific basis for further solving the difficulty in down-referral and improving the hierarchical treatment system and related policies.Methods A total of 1 141 medical workers from different levels of medical institutions in Anyang area were selected as research subjects from March to August 2023.A self-designed questionnaire based on KAP theory and orthogonal experimental design was used to collect data through on-site surveys.Descriptive statistics,exploratory factor analysis,nonparametric tests and binary logistic regression were performed on the data.Results The median and interquartile range scores for each dimension from all medical staff were 16(12,20)for knowledge,34(30,38)for attitude,30(26,36)for practice.Pearson correlation analysis showed a positive correlation between knowledge,attitude and practice.The down-referral questionnaire of medical staff in tertiary hospitals showed that the improvement of KAP total score and lower medical quality,patients with medical insurance,high risk of in-hospital disputes,adequate information sharing between the upper and lower levels,clear referral standards,encouragement of assessment mechanism for downward referral,and increase of monthly income could improve the willingness of medical staff to down-referral of patients with acceptable conditions(P＜0.05).Compared with those without professional titles,the transfer intention of doctors was lower than that of other positions,and the transfer intention of doctoral students was higher than that of undergraduates.The medical staff over 50 years old also had a higher willingness to convert than those under 40 years old(P＜0.05).Conclusion There is still room for improvement in the cognition and implementation of dual-referral of medical staff.The willingness of medical staff in tertiary hospitals to down-referral is related to KAP total score,position,educational background,professional title,monthly income,age group,patient's medical insurance,patient's in-hospital risk,referral standard is clear,subordinate medical quality,information sharing degree and incentive mechanism of down-referral.
万方数据
维普
