背景 紧密型县域医共体的建设对提高县、乡、村医疗资源利用效能,提升基层卫生服务能力起着关键作用,基于患者满意度对紧密型县域医共体的建设进行评价,对完善紧密型县域医共体建设体系具有重要意义.目的 了解江苏省新沂市紧密型县域医共体内就诊患者的就医满意度及其影响因素,为进一步完善紧密型县域医共体建设提供参考.方法 基于安德森模型于 2020-10-22-12-11 对新沂市 1 068 例紧密型县域医共体内的就诊患者进行满意度问卷调查,通过因子分析确定各满意度指标权重并计算总体满意度,并采用单因素和多因素Logistic回归分析探讨新沂市紧密型县域医共体就诊患者满意度的影响因素.结果 本次调查共发放问卷1 100份,回收有效问卷1 068份,有效回收率 97.09%.就诊患者的总体满意度为 64.23%(686/1 068).多因素Logistic回归分析结果显示,职业为企事业单位职工(OR=2.439),医保政策知晓度为比较了解和非常了解(OR比较了解=1.635、OR非常了解=2.840),就诊医院类型为成员医院(OR=1.938),就医类型为住院就诊(OR=1.994),有生理失能(OR=2.268)的患者对紧密型县域医共体满意度更高(P<0.05).结论 个人特征和医疗行为是影响紧密型县域医共体就诊患者满意度的主要因素.应加强紧密型医共体建设,提升核心医院自身医疗服务能力,完善医保支付政策,加大对医共体及相关政策的宣传力度.
Background The construction of compact county medical health community plays a key role in improving the utilization efficiency of rural medical resources and improving the capacity of primary health services.It is of great significance for improving compact county medical community to evaluate its construction based on patient satisfaction.Objective To understand the satisfaction of patients and influencing factors within the compact county medical community in Xinyi,Jiangsu,and provide a reference for further improving the construction of compact county medical community.Methods A questionnaire survey was conducted among 1 068 patients within the compact county medical community from October 22,2020,to December 11,2020 based on the Anderson model.The weight of each satisfaction index was determined by factor analysis and the overall satisfaction was calculated.The influencing factors of patients'satisfaction in the compact county medical community of Xinyi City were discussed by univariate analysis and multivariate Logistic regression analysis.Results A total of 1 100 questionnaires were distributed in this survey,and 1 068 valid questionnaires were recovered,with a valid recovery rate of 97.09%.The overall satisfaction rate of the patients was 64.23%(686/1 068).The results of multivariate Logistic regression analysis showed that occupation of enterprise and institution employee(OR=2.439),knowledge of health insurance policy was relatively(OR=1.635)and very well understood(OR=2.840),attendance at member hospitals(OR=1.938),inpatient visit(OR=1.994),physically disabled(OR=2.268)were associated with higher satisfaction with the compact county medical community(P<0.05).Conclusion Personal characteristics and medical behaviors are the main factors influencing satisfaction of patients within the compact county medical community.It is necessary to strengthen the construction of compact county medical community and the medical service capabilities of core hospitals,improve the medical insurance payment policy,increase the publicity of the medical community and related policies.