School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 100050, China.
BMC Health Serv Res. 2020 Jul 10;20(1):643. doi: 10.1186/s12913-020-05507-9.
To promote the integration of medical resources, Beijing has built medical alliances since 2012, but this reform has not changed the state of disordered medical treatment. Patients are still willing to go to high-level hospitals for medical treatment. What causes patients to prefer high-level hospitals? To explore the reasons behind this preference for high-level medical treatment among patients and to guide patients to make visits in an orderly manner, we conducted this study and compared patients' satisfaction with hospitals of different levels in the context of medical resource integration.
This study conducted a questionnaire survey among 1250 patients who were selected in 18 medical alliances in Beijing from October to December 2016. The study type is a comparative study based on cross-sectional data. Patient satisfaction was the main outcome, and descriptive analysis, chi-square tests, nonparametric tests and binary logistic regression analysis were used. The level of statistical significance was set at p < 0.05.
The overall satisfaction score of the medical alliances was 3.375, and the satisfaction scores of core hospitals and cooperative hospitals were 2.77 and 3.07, respectively. The overall patient satisfaction rate was 44.62%, and the satisfaction rates of core hospitals and cooperative hospitals were 34.34 and 50.43%, respectively. The type of hospital and understanding of medical alliance policy were the factors associated with patient satisfaction with the medical alliance.
The patients' satisfaction with cooperative hospitals was higher than their satisfaction with core hospitals. Although the patients were more satisfied with the service attitude of the cooperative hospitals, they still preferred core hospitals due to their higher expectations for their medical treatment and greater trust in their medical technology. It is necessary to explore the establishment of closed medical alliances under the unified management of human and financial resources to enable medical alliances to become a community of common interests and provide integrated medical services for patients.
为促进医疗资源整合，北京自 2012 年以来组建了医疗联合体，但这一改革并未改变医疗无序就诊的状况，患者仍然愿意到大医院就诊。患者为何偏好去大医院？为探讨患者偏好大医院就诊的原因，引导患者有序就医，我们在医疗资源整合背景下，比较了不同级别医院患者的满意度。
本研究于 2016 年 10 月至 12 月，采用问卷调查法，在北京市 18 个医联体中选取 1250 例患者进行调查，研究类型为基于横断面数据的对比研究。以患者满意度为主要结局，采用描述性分析、卡方检验、非参数检验、二分类 Logistic 回归分析，检验水准α=0.05。
医联体总体满意度评分为 3.375 分，核心医院和合作医院的满意度评分分别为 2.77 分、3.07 分。总体患者满意度为 44.62%，核心医院和合作医院的满意度分别为 34.34%、50.43%。医院类型和对医联体政策的了解是影响患者对医联体满意度的因素。
合作医院的患者满意度高于核心医院。患者虽然对合作医院的服务态度更满意，但由于对治疗效果的期望更高、对医疗技术的信任更大，仍更偏好核心医院。有必要探索在人财物统一管理下建立紧密型医联体，使医联体成为利益共同体，为患者提供连续性的医疗服务。
