Analysis of the Satisfaction and Influencing Factors of Chronic Disease Patients with Upward and Downward Refer-ral Services from the Perspective of Medical Prevention Integration Based on Survey of Township Primary Medical Insti-tutions in Jiangxi Provinc
Background Chronic non-communicable diseases have become the most severe health challenge and the main source of disease burden in China,which have extremely complex pathogenesis,involving the interaction of multiple factors such as genetics,environment,and lifestyle,resulting in a long and persistent disease course.Objective To understand the satisfaction status and influencing factors of chronic disease patients in grassroots medical institutions with referral services from the perspective of medical prevention integration,provide strong data support and reference for optimizing the referral service process and impro-ving service quality,and achieve more accurate,efficient,and humane medical care for chronic disease patients.Methods Strati-fied random sampling method was used to select the patients with hypertension and diabetes who visited the township medical insti-tutions in Wuyuan,Wanzai,Pingxiang,Jiujiang and other areas,where has a distinctive feature of integration of medical treat-ment and prevention work in Jiangxi Province.A questionnaire survey was conducted to understand the patients'satisfaction with up and down referral services and its influencing factors,which was analyzed by using independent sample testing,univariate anal-ysis,Kruskal Wallis H-test and linear regression.Results 2951 patients with chronic diseases were included in this study,inclu-ding 1504 patients with hypertension and 1447 patients with diabetes.The score of hypertension and diabetes patients'satisfaction with up and down referral services was 4.32±0.77 and 4.21±0.82,respectively,indicating an overall high satisfaction.The re-gression analysis results from the questionnaire data of hypertensive patients showed that factors of family annual income,aware-ness of medical and preventive integration services,and evaluation of medical and preventive integration services could influence the satisfaction of referral services(P<0.05).And the factors influencing the satisfaction of diabetes patients with upper and lower referral services were residence,annual family income,cognition of medical and preventive integration services,and evalua-tion of medical and preventive integration services(P<0.05).Conclusion Chronic disease patients with lower annual household income have relatively higher satisfaction with referral services.And there is a positive correlation between the recognition and e-valuation of integrated medical and preventive services and the satisfaction of referral services for chronic disease patients.It is recommended for primary healthcare institutions to strengthen doctor-patient trust,transform patients'healthcare seeking mindset,establish a patient-centered primary healthcare system,enhance the comprehensive capabilities of general practitioners,and pro-vide high-quality healthcare services to improve patients'evaluation on services,ultimately leading to higher satisfaction with ref-erral services among chronic disease patients.
medical and preventive integrationchronic diseasesprimary medical institutionsup-down referral
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