联合分析法下患者就医偏好研究以及对分级诊疗制度的启示

摘要

Objective To study the patients' preferences,provide suggestions on guiding patients for medical treatment reasonably and perfecting graded medical treatment.Methods From February 13th to March 3rd,2017,a questionnaire was designed by conjoint analysis,in order to conduct the questionnaire survey on 194 patients totally,who were from the First People's Hospital of Zhengzhou,He'nan Provincial People's Hospital and others total of 6 medical institutions.Conjoint analysis of data was conducted by SPSS 19.0.Results The results of conjoint analysis showed the patients were sensitive to the quality of care mostly,followed by the level of medical institutions.The patients got the highest utility value based on the analog combination,which included general hospital,just waiting for 30 min,good service quality,cost of 120 RMB and 85％ reimbursement rate.Conclusion At present,patients have lower confidence in community health institutions.Patients need to improve blindness in medical treatment.Differentiated health care policy has little incentive for patients.As a result,it is suggested that graded medical treatment should be improved from the aspects of the community hospital development,health education and medical institutions,etc..%目的 研究患者的就医偏好,为合理引导患者就医,完善分级诊疗制度提供建议.方法 运用联合分析法设计问卷,于2017年2月13日～3月3日随机对郑州市第一人民医院、河南省人民医院等6家医疗机构194例门诊患者进行问卷调查,运用SPSS 19.0对数据进行联合分析.结果 联合分析结果显示,患者对医疗服务质量最敏感,其次为医疗机构水平.患者对综合医院、等候30 min、服务质量好、费用120元、报销比例85％的模拟组合效用值最高.结论 患者对于社区卫生机构的信任度较低,就医盲目性仍然存在,差异化的医保政策对患者激励作用不大;建议从社区卫生机构建设、宣传教育、医保机制等方面完善分级诊疗制度.