| 摘要: |
| 目的 分析高血压患者在农村医疗服务网络接受协调性和连续性服务的提供状况,为改进患者的整合服务利用提供决策参考。方法 根据国内外文献,以自行编制服务协调性和连续性提供的问卷为工具,调查数据采用描述性统计分析。结果 49.6%的患者伴有1种及以上疾病,约73.0%在乡镇卫生院有就医经历,到过2家及以上机构就医的占51.3%;在乡村两级治疗效果不佳的患者,能够获取村医和乡镇医生推荐转诊机构的比重最大,分别为28.4%和68.7%;上级医生能够根据下级机构相关诊疗信息连续诊疗的不到43.0%,下级医生能够根据前期诊疗信息继续诊疗的比例刚超4成;“上转容易、下转难”现象同样存在。 结论 农村慢性病患者的患病特点增加了在农村纵向医疗机构就诊的几率,但该网络提供连续性和协调性服务的程度却不高,应加强农村三级医疗机构间的全面整合。 |
| 关键词: LINE-HEIGHT: 12pt LAYOUT-GRID-MODE: char" align="left">农村医疗服务网络;连续性;协调性;双向转诊 |
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| Study on Coordinated and Continuous Services Utilization of Rural Patients with Hypertension |
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| Abstract: |
Objective
To analyze the coordination and continuity of service delivery for hypertension patients in rural health network, so as to provide references for improving integrated service utilization. Methods Self-developed questionnaire of service coordination and continuity delivery according to the research literature at home and abroad was used as the tool, and the data was analyzed by descriptive statistics. Results 49.6% patients were accompanied by one or more diseases. About 73.0% had seeking care experience in township health centers. Patients with seeking care to two or more medical institutions accounted for 51.3%. Recommending referral institutions for patients with poor therapeutic effect by grassroots doctors were the biggest proportion with 28.4% and 68.7% respectively. The proportion that superior doctors treating patients according to the related information from subordinate institutions was less than 43.0%, the proportion that junior doctors continuing to treat referral patients according to early diagnosis and treatment information was just over 40%. Easier upward referral but harder downward referral also existed among medical settings of different levels. Conclusion The disease characteristics of rural patients increased the possibility of seeking care among vertical medical institutions, but the level of continuity and coordination service delivery was not high in this network. So all-sided service integration to rural three-tier health institutions should be strengthened. |
| Key words: LINE-HEIGHT: 12pt LAYOUT-GRID-MODE: char" align="left">rural health service network, continuity, coordination, duel referral |