上海市嘉定区卫生系统反应性及居民满意度调查分析(1)
摘 要 目的：分析居民卫生服务可及性及医疗服务满意度情况，为提升辖区内卫生系统反应性提供数据支持。方法：采用多阶段分层整群随机抽样方法，于2018年9月抽取上海市嘉定区5个镇/街道、每个街道2个村/居委、每个村/居委60户家庭为调查对象，共计纳入600户家庭。调查问卷内容包括卫生服务可及性，居民对就医环境、医护人员态度与沟通情况及卫生费用的满意度评价等。结果：249名居民家距离最近的医疗机构不足1 km，589名居民家附近最近的医疗机构为基层医院。调查前2周内有482名居民前往各類医疗机构就诊，前往基层医疗机构就诊的比例最高(71.78%)，二、三级医院的就诊比例分别为21.58%与5.39%。门诊及住院患者中，认为就诊机构环境较好的比例分别为81.74%与65.58%，住院患者对医护人员住院治疗方案解释的清晰程度及倾听病情认真程度均较为满意，总体满意度均在75.00%左右。不同级别医疗机构就诊患者的总体满意度差异有统计学意义(P<0.001)，不同级别医疗机构住院患者的总体满意度差异没有统计学意义(P=1.000)。结论：嘉定区基层医疗机构卫生服务可及性较好，患者对医疗机构的总体满意度较高，但综合医院患者的就诊满意度不高，患者对诊疗或住院费用的满意度较低。降低医疗服务与药品收费价格、遏制过度医疗、降低居民就诊费用等问题仍然是未来医疗行业改革面临的难题。
关键词 卫生系统；反应性；满意度
中图分类号：R197 文献标志码：A 文章编号：1006-1533(2020)10-0015-04
Investigation and analysis of health system responsiveness and residents’ satisfaction in Jiading District of Shanghai
ZHENG Yanhui1， XU Yuping2
(1.Health Committee of Jiading District， Shanghai 201899， China；2.Medical Association of Jiading District， Shanghai 201899， China)
ABSTRACT Objective： To analyze residents’ accessibility to the health service and satisfaction with medical services in order to provide scientific data for improving the responsiveness of the health system in the jurisdiction. Methods： In September 2018， a multi-stage stratified cluster random sampling method was used to select 5 towns/neighborhood committees， two villages/ residents’ committees in each neighborhood committee and 60 households in each village/residents’ committee in Jiading District of Shanghai were selected as survey objects， and a total of 600 households were included. The questionnaire included access to health services， residents’ satisfaction with the environment for medical treatment， attitudes and communication of medical staff， and satisfaction evaluation of health expenses. Results： There were 249 residents having access to a medical institution within 1 km and the nearest medical institution close to 589 residents was a primary hospital. In the 2 weeks before the survey， 482 residents visited various medical institutions， most of them went to primary medical institutions(71.78%)， and the proportion of visits to secondary and tertiary hospitals was 21.58% and 5.39%， respectively. The satisfaction with medical institutions’environment among outpatients and inpatients was 81.74% and 65.58%， respectively， the inpatients were satisfied with the clarity of the medical staff’s explanation of the hospitalization treatment plan and the seriousness of listening to the disease， and the overall satisfaction was about 75.00%. The difference in overall satisfaction among patients at different levels of medical institutions was statistically significant(P<0.001). There was no statistically significant difference in the overall satisfaction of hospitalized patients at different levels of medical institutions(P=1.000). Conclusion： The access to health services in primary medical institutions in Jiading District is better， and the overall satisfaction of patients with medical institutions is higher， however， the satisfaction of patients in general hospitals is not high， and patients’ satisfaction with the costs of diagnosis and treatment or hospitalization is low. Reducing the prices of medical services and medicines， curbing excessive medical treatment， and reducing the cost of treatment are still the challenges for reforming the health system in the future., http://www.100md.com(郑艳辉 胥玉萍)
关键词 卫生系统；反应性；满意度
中图分类号：R197 文献标志码：A 文章编号：1006-1533(2020)10-0015-04
Investigation and analysis of health system responsiveness and residents’ satisfaction in Jiading District of Shanghai
ZHENG Yanhui1， XU Yuping2
(1.Health Committee of Jiading District， Shanghai 201899， China；2.Medical Association of Jiading District， Shanghai 201899， China)
ABSTRACT Objective： To analyze residents’ accessibility to the health service and satisfaction with medical services in order to provide scientific data for improving the responsiveness of the health system in the jurisdiction. Methods： In September 2018， a multi-stage stratified cluster random sampling method was used to select 5 towns/neighborhood committees， two villages/ residents’ committees in each neighborhood committee and 60 households in each village/residents’ committee in Jiading District of Shanghai were selected as survey objects， and a total of 600 households were included. The questionnaire included access to health services， residents’ satisfaction with the environment for medical treatment， attitudes and communication of medical staff， and satisfaction evaluation of health expenses. Results： There were 249 residents having access to a medical institution within 1 km and the nearest medical institution close to 589 residents was a primary hospital. In the 2 weeks before the survey， 482 residents visited various medical institutions， most of them went to primary medical institutions(71.78%)， and the proportion of visits to secondary and tertiary hospitals was 21.58% and 5.39%， respectively. The satisfaction with medical institutions’environment among outpatients and inpatients was 81.74% and 65.58%， respectively， the inpatients were satisfied with the clarity of the medical staff’s explanation of the hospitalization treatment plan and the seriousness of listening to the disease， and the overall satisfaction was about 75.00%. The difference in overall satisfaction among patients at different levels of medical institutions was statistically significant(P<0.001). There was no statistically significant difference in the overall satisfaction of hospitalized patients at different levels of medical institutions(P=1.000). Conclusion： The access to health services in primary medical institutions in Jiading District is better， and the overall satisfaction of patients with medical institutions is higher， however， the satisfaction of patients in general hospitals is not high， and patients’ satisfaction with the costs of diagnosis and treatment or hospitalization is low. Reducing the prices of medical services and medicines， curbing excessive medical treatment， and reducing the cost of treatment are still the challenges for reforming the health system in the future., http://www.100md.com(郑艳辉 胥玉萍)