Yu Wenya, Li Meina, Ye Feng, Xue Chen, Zhang Lulu
Department of Military Health Service Management, College of Military Health Service Management, Second Military Medical University, Shanghai, China.
Department of Medical Affairs, No. 187th hospital of PLA, Haikou, China.
BMJ Open. 2017 Nov 1;7(10):e016418. doi: 10.1136/bmjopen-2017-016418.
This study aimed to assess patients' healthcare-seeking preferences in mild, chronic, and serious illness; identify influential factors; and examine the reasons underlying patients' healthcare-seeking preference.
A retrospective study.
The study was conducted in 14 tertiary hospitals in Shanghai, China.
Questionnaires were distributed to 1519 patients, and 1114 were completed and returned. All patients participated in the study voluntarily, provided written informed consent, and possessed the ability to complete the questionnaire.
We measured and compared preferences and choice of healthcare providers in patients if they had experienced mild, chronic, or serious illness.
More than 50% of participants, including those who were >60 years of age, had consulted a doctor more than three times during the preceding year, were single, and were most likely to decide not to seek medical treatment. Community health facilities were the most frequently selected healthcare provider in mild illness. In addition, patients who had no personal preference, did not express a preference for a good environment or first-class medical technology, were concerned about close proximity and short waiting times, and pursued low medical costs were most likely to choose a community health facility. General hospitals were the most frequently selected healthcare provider in chronic and serious illness. In addition, patients who earned higher monthly incomes, did not pursue low medical costs, were not concerned about short waiting times or close proximity, and expressed a preference for first-class medical technology, were most likely to choose general hospitals.
Patients' healthcare-seeking preference was influenced mainly by healthcare providers' characteristics, illness severity, and sociodemographic characteristics. These findings indicate that patients' current healthcare-seeking preference was not ideal and requires optimisation.
本研究旨在评估患者在轻症、慢性病和重症情况下的就医偏好；确定影响因素；并探究患者就医偏好背后的原因。
一项回顾性研究。
该研究在中国上海的14家三级医院进行。
向1519名患者发放问卷，1114份问卷填写并返回。所有患者均自愿参与研究，提供书面知情同意书，并具备完成问卷的能力。
我们测量并比较了患者在经历轻症、慢性病或重症时对医疗服务提供者的偏好和选择。
超过50%的参与者，包括60岁以上的人群，在前一年咨询医生超过三次，单身，且最有可能决定不寻求医疗治疗。社区卫生机构是轻症时最常被选择的医疗服务提供者。此外，没有个人偏好、不看重良好环境或一流医疗技术、关注距离近和等待时间短且追求低医疗成本的患者最有可能选择社区卫生机构。综合医院是慢性病和重症时最常被选择的医疗服务提供者。此外，月收入较高、不追求低医疗成本、不关注等待时间短或距离近且偏好一流医疗技术的患者最有可能选择综合医院。
患者的就医偏好主要受医疗服务提供者的特征、疾病严重程度和社会人口学特征的影响。这些发现表明患者当前的就医偏好并不理想，需要优化。
