摘要
目的 分析公立医院医生向下级医疗机构转诊患者的意向及影响因素.方法 于 2022 年 1 月至 2024 年 1 月对杭州市萧山区中医院医共体总院的医生进行问卷调查,共抽取 377 名医生就其向下级医疗机构转诊患者的意向进行调查,分析其影响因素.结果 有向下级医疗机构转诊患者意向者共 297 名,占 78.78%.分级诊疗认知水平、上下级机构分级诊疗业务交流频率、下转态度、主观规范、自觉行为控制评分与医生向下级医疗机构转诊患者意向有关(p<0.05);分级诊疗认知水平低及小于中位数的下转态度评分、主观规范评分、自觉行为控制评分均为影响医生向下级医疗机构转诊患者意向的因素(p<0.05);下转态度、主观规范、自觉行为控制与医生下转意向均呈正相关(p<0.05).结论 公立医院医生向下级医疗机构转诊患者的意向较高并受分级诊疗认知水平、下转态度、主观规范、自觉行为控制的影响,实施针对性改善措施有助于提高医生的转诊意向.
Abstract
Objective To analyze the intention and influencing factors of physicians'downward referral of common diseases in public hospitals.Methods A questionnaire survey was conducted from January 2022 to January 2024 among the physicians of the general hospital of Xiaoshan District Hospital of Traditional Chinese Medicine in Hangzhou,and a total of 377 physicians were selected to investigate their intention to refer patients to lower-level medical institutions and analyze their influencing factors.Results A total of 297 physicians,accounting for 78.78%,had the intention to refer patients to lower-level medical institutions.The cognition of tiered medical system,the frequency of medical service communication,down-referral attitude,subjective norms,and conscious behavioral control scores were related to the physicians'intention to refer patients to lower-level medical institutions(p<0.05).Low cognitive level of tiered medical system and below the median score of down-referral attitude,subjective norm score,and conscious behavior control score were the factors affecting physicians'intention to refer patients to lower-level medical institutions(p<0.05).The attitude,subjective norm,and conscious behavior control were positively correlated with the intention of downward referral conversion(p<0.05).Conclusion Physicians'intention of downward referral for common diseases in public hospitals is high and affected by the cognitive level of tiered medical system,downward referral attitude,subjective norms,and conscious behavior control.Targeted improvement measures are helpful to improve physicians'referral intention.
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