Objective: To analyze the flowdirection of the patients in outpatient and emergency of different kinds of medical institutions in China, evaluate the implementing effects of hierarchical diagnosis and treatment, and explore the influencing factors of the patients on hierarchical diagnosis and treatment. Method: The authors collected some data on medical service in China Health and Family Planning Statistics Yearbook from 2015 to 2018, made the descriptive analysis on the patients' flowin outpatients of different medical institutions, and investigated the patients' factors restricting the implementation of hierarchical diagnosis and treatment. Result: The number of the patients seeking diagnosis and treatment in outpatient and emergency of all kinds of medical institutions is on the rise but patients still flocked to large-scale hospitals for medical treatment, which reflects the lowrecognition of hierarchical diagnosis and treatment among residents and the inadequate propaganda and education in communities. Conclusion: The flowdirection of the patients in outpatient and emergency of medical institutions is not rational, the effect of hierarchical diagnosis and treatment is not prominent, and the cognition of hierarchical diagnosis and treatment of the residents is low. All these block the development of hierarchical diagnosis and treatment.%目的 分析我国不同类型医疗机构门急诊患者就医流向, 评价分级诊疗的实施效果, 探讨影响分级诊疗实施的患方因素.方法 收集2015至2018年《中国卫生和计划生育统计年鉴》中医疗服务部分资料, 描述性分析各类医疗机构门诊病人就诊流向情况, 并通过问卷, 调查制约分级诊疗实施的患方因素.结果 各类医疗卫生机构门急诊诊疗人次总体呈上升趋势, 患者仍聚集到大医院就诊, 存在居民对分级诊疗的认知度低, 社区宣传教育不到位等因素.结论 医疗机构门急诊病人就医流向仍然不合理, 分级诊疗制度实施效果不显著, 居民对分级诊疗的认知程度不高, 制约着分级诊疗的开展.
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