School of Public Health, Shandong Second Medical University, No. 7166 Baotong West Street, Weicheng District, Weifang City, Shandong, China.
Hepatic biliary pancreatic surgery, Yidu Central Hospital Of Weifang, No. 5168 Jiangjunshan Road, Qingzhou City, Weifang City, Shandong, China.
BMC Health Serv Res. 2024 Oct 24;24(1):1278. doi: 10.1186/s12913-024-11775-6.
Improving patients' experience, enhancing patients' trust and improving the willingness to see a doctor are the key to the real implementation of the "gatekeeper" role of residents' health in township health centers. At present, in the field of health management, the research on the relationship between the three is relatively limited. The purpose of this study is to explore the current situation of patients' experience, patients' trust and willingness to see a doctor in township health centers, and further explore the relationship between the three, so as to provide a theoretical basis for improving the overall service and management quality of township health centers.
In this study, a cross-sectional survey was conducted in Shandong Province, China from July to October 2020. We used a structured questionnaire to collect data, which included general information, medical information, patient experience, patient trust, and willingness to see a doctor. Patient experience, patient trust, and willingness to see a doctor were evaluated using the Likert 5-point scoring method, with a maximum score of 5. The higher the score, the better the patient experience, the greater the patient trust, and the stronger the willingness to see a doctor. SPSS21.0 was used to describe the current situation, test the reliability and validity, and analyze the Pearson correlation. AMOS23.0 was used for structural equation modeling.
The score of willingness to see a doctor was 3.84 ± 0.62. The score of patient experience was 3.81 ± 0.47, and the score of patient trust was 3.81 ± 0.60, which was a lower score compared to other studies in the same period. Both patient experience and patient trust both had a directly positive impact on the willingness to see a doctor, and the impact coefficients were 0.19 and 0.68, respectively. Patient experience has a direct positive impact on patient trust, with an impact coefficient of 0.74. Patient trust played a partial mediating role in the relationship between patient experience and willingness to see a doctor, and the impact coefficient was 0.50.
If the reform of China's healthcare system is to realize the goal of "not leaving the countryside for minor illnesses and not leaving the county for serious illnesses" increasing the willingness of patients to see a doctor at the grass-roots level primary hospitals is key. In addition, the government should vigorously promote the construction of township health centers and stimulate the vitality of grass-roots health institutions. If primary hospitals want to "catch" the demand of patients, they must improve patient experience and enhance patient trust.
提高患者体验、增强患者信任和提高就医意愿是实现乡镇卫生院居民健康“守门人”角色的关键。目前，在健康管理领域，对这三者关系的研究相对有限。本研究旨在探讨乡镇卫生院患者体验、患者信任和就医意愿的现状，并进一步探讨三者之间的关系，为提高乡镇卫生院整体服务和管理质量提供理论依据。
本研究采用横断面调查方法，于 2020 年 7 月至 10 月在山东省进行。我们使用结构化问卷收集数据，内容包括一般信息、医疗信息、患者体验、患者信任和就医意愿。患者体验、患者信任和就医意愿采用李克特 5 级评分法进行评估，最高得分为 5 分。得分越高，患者体验越好，患者信任度越高，就医意愿越强。采用 SPSS21.0 描述现状，检验信度和效度，并进行 Pearson 相关分析。采用 AMOS23.0 进行结构方程建模。
就医意愿得分为 3.84±0.62。患者体验得分为 3.81±0.47，患者信任得分为 3.81±0.60，与同期同领域其他研究相比得分较低。患者体验和患者信任均对就医意愿有直接正向影响，影响系数分别为 0.19 和 0.68。患者体验对患者信任有直接正向影响，影响系数为 0.74。患者信任在患者体验与就医意愿之间起部分中介作用，影响系数为 0.50。
如果中国医疗体系改革要实现“小病不出村，大病不出县”的目标，提高基层医院患者的就医意愿是关键。此外，政府应大力推进乡镇卫生院建设，激发基层医疗机构活力。如果基层医院想要“抓住”患者的需求，就必须提高患者体验，增强患者信任。
