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| Survey of the cognition, attitude and medical treatment behavior of urban and rural residents on the hierarchical diagnosis and treatment system in a city |
| Liu Haixia1,2, Chen Shuai1, Du Qing1, Hu Naibao1, Sun Hongwei1,Zhao Haiquan3. |
1 School of Public Health and Management, Binzhou Medical University, Yantai 264003, China;
2 School of Public Health, Health Science Center, Xi′an Jiaotong University, Xi′an 710061, China;
3 Binzhou Center for Disease Control and Prevention, Binzhou 256600, China |
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Abstract Objective To investigate the residents′ cognition, attitude, medical seeking behavior and its influencing factors through questionnaire survey, and provide reference for effectively promoting and improving hierarchical medical system.Methods A selfdesigned questionnaire was used to conduct an onsite questionnaire survey on some urban and rural residents in a city. Descriptive statistics methods were used to analyze the residents′ cognition, attitude and medical behavior choice, and multiple correspondence analysis was used to analyze the influencing factors of residents′ willingness to transfer to lower level hospitals.Results (1) The awareness rate of hierarchical medical system was 36.06%, and the awareness rates of twoway referral (9.83%) and medical association (18.03%) were relatively low. And 64.75% of the respondents were very satisfied or relatively satisfied with the hierarchical medical system. The main reasons for dissatisfaction were that the medical conditions of primary medical institutions were poor, the hierarchical medical system in different regions was lack of unified norms, and the medical security system was not perfect. (2) The top three medical institutions preferred by residents were: County/city/district hospital (31.97%), health room/station (22.13%), and private clinic (21.31%). The main reasons affecting their choice of medical institutions were: severity of diseases, advanced level of medical equipment and medical insurance reimbursement. (3)Multiple correspondence analysis showed that residents living in rural areas with family income less than 20 000 yuan would refer to lower level hospitals for treatment depending on the situation. Male, inservice, with junior high school education or below, income of 20 000 to less than 40 000 yuan or 60 000 to less than 80 000 yuan, who did not agree with the implementation of hierarchical medical system in China, were more reluctant to transfer to lower level hospitals for the treatment. Conclusions Residents′ awareness of the hierarchical medical system was low. The main reasons for not choosing grassroot medical treatment or referral were that the Internet mechanism of hierarchical medical system was imperfect, the quality of primary medical services was not trusted, and the lack of grassroot talents. It was suggested that we should strengthen the Internet construction in the process of hierarchical medical system, improve the level of primary medical service and medical environment, and promote the quality of medical resources to the primary medical institutions.
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Received: 30 June 2020
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