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孙刚, 龚静. 分级诊疗背景下医疗检查结果互认实施现状及影响因素分析[J]. 中国公共卫生, 2019, 35(11): 1528-1531. DOI: 10.11847/zgggws1119771
引用本文: 孙刚, 龚静. 分级诊疗背景下医疗检查结果互认实施现状及影响因素分析[J]. 中国公共卫生, 2019, 35(11): 1528-1531. DOI: 10.11847/zgggws1119771
Gang SUN, Jing GONG. Implementation and influencing factors of inter-hospital mutual recognition of medical examination results under hierarchical diagnosis and treatment policy[J]. Chinese Journal of Public Health, 2019, 35(11): 1528-1531. DOI: 10.11847/zgggws1119771
Citation: Gang SUN, Jing GONG. Implementation and influencing factors of inter-hospital mutual recognition of medical examination results under hierarchical diagnosis and treatment policy[J]. Chinese Journal of Public Health, 2019, 35(11): 1528-1531. DOI: 10.11847/zgggws1119771

分级诊疗背景下医疗检查结果互认实施现状及影响因素分析

Implementation and influencing factors of inter-hospital mutual recognition of medical examination results under hierarchical diagnosis and treatment policy

  • 摘要:
      目的  了解医疗检查结果互认的现状及其影响因素,为政府决策提供建议。
      方法  2018年2 — 4月,采用方便抽样的方式对全国30个省份的551名患者进行网络和纸质问卷调查。
      结果  248名患者(47.69 %)没听说过医检互认,很清楚医检互认仅有32名患者(6.15 %),其中经济欠发达地区和经济发达地区不了解医检互认的患者分别为202人(59.06 %)和46人(25.84 %),差异有统计学意义(P = 0.000);对于医疗检查结果互认实施效果,认为其有利于减少检查费用和检查程序的有369名患者(70.96 %),其中不同经济水平的地区之间(经济发达区197人,占32.40 %;经济欠发达区172人,占75.11 %)、综合医改试点地区(162人,占34.54 %)和其他地区(207人,占34.79 %)患者评价一致。针对重复检查,经济欠发达地区和经济发达地区认为重复检查没必要、费时费钱的患者分别为48人(19.20 %)和27人(10.00 %),差异有统计学意义(P = 0.042)。在影响医检互认的因素上,38.27 %(199/520)的患者选择检查结果容易发生变化,22.12 %(115/520)的患者选择不同医院检查仪器精准度;综合医改试点地区和其他地区认为检查结果容易发生变化是阻碍医检互认首要原因的患者分别为120人(42.56 %)和79人(33.79 %),差异有统计学意义(P = 0.000)。
      结论  医疗检查结果互认的实施情况总体较好,但仍需加强基层医院高技术水平医生的配备、细化医检互认项目的认可标准,此外需要加大对医疗检查结果互认的宣传,增进患者了解,推动我国医改的不断完善与发展。

     

    Abstract:
      Objective  To examine the implementation of inter-hospital mutual recognition of medical examination results (IH-MR-MER) and its influencing factors and to provide references for governmental agencies' policy making.
      Methods  We conducted an online or on-site questionnaire survey among 551 adult patients recruited with convenient sampling in 30 provinces across China between February and April 2018.
      Results  Of all the participants, 47.69% (248) reported not being aware of IH-MR-MER and the ratio was significantly higher among the participants in economically less-developed regions than among those in developed regions (59.06% vs. 25.84%, P < 0.001); only 6.15% of the participants reported knowing completely about IH-MR-MER. Among all the participants, 70.96% (369) believed that IH-MR-MER could decrease medical examination cost and simplify examination procedures; the ratio was unsignificantly higher among the participants in economically less-developed regions than among those in developed regions (75.11% vs. 32.40%) but the ratio (34.54%) among the participants in pilot regions of comprehensive medical reform was similar to that among those in other regions (34.79%). The proportion of the participants considering repeated examination being unnecessary and both time- and money-consuming was significantly higher in economically less-developed regions than in the developed regions (19.20% vs. 10.00%, P = 0.042). There were 38.27% (199/520) and 22.12% (115/520) of the participants thought the variability of medical examination results and difference in accuracy of instruments for medical examination being the two major hindering factors for IH-MR-MER. More participants in pilot regions of comprehensive medical reform considered the variability of medical examination results as a major hindering factor for IH-MR-MER than the participants in other regions (42.56% vs. 33.79%, P < 0.001).
      Conclusion  The implementation of inter-hospital mutual recognition of medical examination result policy is generally good but efficient measures should be adopted to promote the implementation of the policy.

     

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