Analysis Of Treatment Seeking Behaviors And Influencing Factors Of Rural Residents In A County Of Shanxi Province Based On Hierarchical Diagnosis And Treatment

Objective: Comprehensively understand the implementation background and institutional connotation of the hierarchical diagnosis and treatment system in Shanxi Province,understand the characteristics of health seeking behaviors of rural residents in a county of Shanxi province and the existing problems,analyze the main factors affecting the current rural residents’ health seeking behaviors,and dig deeper into the causes of rural residents’ health seeking behaviors.In order to further guide rural residents in orderly medical treatment and to promote the effective implementation of the hierarchical diagnosis and treatment system to provide reference.Methods: 1.Questionnaire survey Using a three-stage stratified cluster random sampling method,3 sample townships are randomly selected in a county of Shanxi Province,and each sample township randomly selected 1 sample village and 3 sample villages in total.A household survey is conducted for each sample village.Each sample village randomly selectes 200 households with a total of 600 households.Each household selectes a representative villager to conduct a survey,and finally determined 600 survey respondents.According to self-designed survey questionnaire for “rural residents’ treatment seeking behaviors and influencing factors in a county of Shanxi Province based on hierarchical diagnosis and treatment”,a self-administered questionnaire survey is conducted.The content of the questionnaire is divided into four aspects: demographic characteristics,medical decision-making,medical security system and hierarchical diagnosis and treatment.After the questionnaires are collected,they are double entered by Epi Data3.1,and a database of valid questionnaires is established.SPSS22.0 software is used for descriptive analysis,chi-square test,analysis of variance,and logistic regression analysis.The questionnaire has a good reliability and validity,and the Cronbachα coefficient is 0.809.2.Grounded theory The method of intentional sampling in "non-probability sampling" is adopted to determine the research object according to the purpose of the research and the subjective judgment of the researcher;the process of theoretical sampling is accompanied by continuous interviews until all categories are saturated,and finally 23 interviewees are identified.Basing on the grounded theory method,on the basis of the original data,through continuous comparisons,three levels of open coding,axis coding,and selective coding are used to find core genera,and the theoretical framework is finally constructed after induction and deduction.Nviro-11 qualitative research analysis software is used to collate and analyze interview data.Results: 1.The treatment seeking behaviors of rural residents in a county of Shanxi Province In the selection of medical treatment routes,45.7% of the residents chose to go to the village health room first and then go to the county-level hospitals and the higher level hospitals;in the doctor’s choice,46.2% of the residents chose Chinese medicine,53.8% of the residents chose western medicine;in the medical treatment of minor illnesses,40.3% of the residents chose to go to the village health room for medical treatment,24.8% of the residents chose self-care,and only 12.5% of residents chose to go to the township health center;in the medical treatment of patients with major illnesses,46.5% of the residents chose a county-level hospital for medical treatment,37.8% of the residents chose to go to provincial and municipal hospitals,and only 7.2 residents chose township health center for medical treatment;In the choice of place for drug purchase,41.0% of residents chose village health room to purchase drugs,28.3% of residents chose private/specialized pharmacies to purchase drugs,and only 16.8% of residents chose township health center to purchase drugs.The analysis found that rural residents in the sample area have relatively low utilization of health services in township health center.2.Influencing factors of Rural Residents’ health seeking behaviors in a county of Shanxi Province The survey find that rural residents’ residence,age,education level,occupation,self-assessment of health status,medical security system,and knowledge of hierarchical diagnosis and treatment systems are the main factors affecting rural residents’ treatment seeking behaviors.3.A study on the Grounded Theory of influencing rural residents’ health seeking behaviors in a county of Shanxi Province Using the Grounded Theory approach,a total of 230 concepts relate to rural residents’ medical behavior are obtained through open coding.Finally,through continuous comparison,22 categories are classified and identified;and through the axis coding,the five main categories of “preference for medical treatment”,“development of rural doctors”,“township health center”,“medical security system”,and “hierarchical diagnosis and treatment” are further summarized;By selecting coding and combining with the results of quantitative research,the three core categories of “behavioral subject”,“health care institution” and “policy system” were finally integrated,and the theoretical framework is constructed.Conclusion: 1.Most residents chose to go to the village health room for medical treatment and self-care when they are ill.When the students are seriously ill,most residents chose county-level hospitals and provincial and municipal hospitals for treatment.Although the township health centers are the backbone of the three-tiered rural health service network,because rural residents have psychological prejudice against them,relatively few residents choose to go to township health centers for medical treatment.2.Rural residents have high expectations of rural doctors,but most rural doctors have low medical skills.Rural residents have relatively little trust in their medical service capabilities,and rural doctors have not been able to give full play to the role of their rural three-tier health service network.3.The medical insurance system for urban and rural residents implements differentiated payments in the proportion of payments.Although to a certain extent it guides the reasonable diversion of rural residents,the range of reimbursement and reimbursement catalog still cannot meet the increasing medical and health needs of rural residents.4.Rural residents are generally less well-educated and have lower awareness of health care policies.We should pay attention to the health education and policy propaganda of rural residents,and implement the implementation of the policy in a way that is easy to understand and accept by rural residents.