Xie Xianyu, Zhao Zijun, Wu Qinde
Department of Medical Administration, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China.
School of Public Administration & Law, Fujian Agriculture and Forestry University, Fuzhou, Fujian, People's Republic of China.
Patient Prefer Adherence. 2023 Oct 5;17:2475-2485. doi: 10.2147/PPA.S426915. eCollection 2023.
This study aimed to analyze first-choice medical institutions for middle-aged and older adults in Fujian Province to promote the development of hierarchical diagnosis and treatment for them.
Single factor analysis, disordered multi-classification logistic regression, and multiple correspondence classification were used to analyze the influencing factors of first-choice medical institutions for middle-aged and older adults. A total of 486 valid questionnaires were obtained. The questionnaire was based on Health Service Integration Theory and the behavioral model of Andersen.
Age, education level, living area, monthly income, nearest medical institution to home, and integrated health service system understanding significantly influenced respondents' preference of first medical institution. Middle-aged and older adults were more inclined to visit county and municipal hospitals first. The treatment center's proximity was also an important determinant of their first-choice selection of medical care.
To realize high-quality hierarchical diagnosis and treatment and integrated health service system construction, it is important to improve the service capacity of primary medical institutions, increase the training of family doctors, implement the contract coverage of family doctors, optimize the allocation and geographical layout of primary medical institutions, ensure adequate income levels, and promote township hospital staff.
本研究旨在分析福建省中老年人群首选医疗机构情况，以推动其分级诊疗发展。
采用单因素分析、无序多分类逻辑回归及多重对应分类法分析中老年人群首选医疗机构的影响因素。共获得486份有效问卷。问卷基于卫生服务整合理论及安德森行为模型。
年龄、文化程度、居住地区、月收入、距家最近的医疗机构以及对整合型卫生服务体系的了解程度显著影响受访者对首选医疗机构的偏好。中老年人群更倾向于首先前往县市级医院就诊。治疗中心的距离也是他们选择首诊医疗机构的重要决定因素。
为实现高质量分级诊疗及整合型卫生服务体系建设，提高基层医疗机构服务能力、加强家庭医生培训、落实家庭医生签约覆盖、优化基层医疗机构资源配置及地理布局、确保合理收入水平并提升乡镇医院工作人员素质至关重要。
