Study About Patients' Medical Behavior Based On Hierarchical Viewpoints

Research purposes:Under the current social background of the comprehensive implementation of the hierarchical diagnosis and treatment system,implementing the basic medical treatment model of the first-level primary diagnosis,two-way referral,emergency treatment,and linkage between upper and lower levels is emphasized.The patient is an important part of the institutional body,who is closely related to the institution's actual implementation,which the choice of the first-care institution in the patient's medical behavior is consistent with the concept of the first-level diagnosis in the institutional content.The first clinic at the grassroots level is the core link of the hierarchical diagnosis and treatment system.Investigation and research on the behaviors of patients' first-selected clinics helps to further grasp the implementation effect of the hierarchical diagnosis and treatment system.Based on the analysis of the influencing factors of the patient's first-choice institution's selection behavior,the breakthrough points of the problem were identified,corresponding countermeasures and suggestions were proposed.Besides,the comprehensive implementation of the hierarchical diagnosis and treatment system was promoted to achieve a rational allocation of medical and health resources.Content method:From the perspective of grading diagnosis and treatment,under the specific system background to investigate and study the patient's medical behavior,which focus on the patient's willingness and actual implementation of the grading diagnosis and treatment system.It also comprehensively study the influence of the individual and social factors that affect the patient's choice of first-time clinic selection mechanism,and further explore the specific influencing mechanisms of each factor,and also analyze the current status and development prospects of the hierarchical diagnosis and treatment system from the patient level.By consulting literature and related policies and regulations,we have a comprehensive understanding of the research background and domestic and international research status of the thesis,designing supporting questionnaires,and adopting pre-investigation methods to formally put the questionnaire into use after it has been revised and improved.In the municipal administration of Zhejiang Province,some patients were randomly selected to carry out a questionnaire survey to collect relevant data.With the help of spss20.0 analysis tools,medical behavior research based on a hierarchical diagnosis and treatment system was conducted.Research results:During the actual survey process,a total of 317 questionnaires were distributed.After eliminating logical errors and incomplete questionnaires,300 valid questionnaires were selected to conduct corresponding data analysis.Of the 300 patient population,137 were males and 163 were females.81(27.0%)had knowledge of the grading system,Only 5 of these patients said they were reluctant to follow the grading system and another 76(93.8%)patients showed a positive willingness;There were 146(48.7%)patients who did not understand the grading system,of whom 85(58.2%)were willing to follow the grading system,and 61 were unwilling to follow the grading system.Of the 73(24.3%)patients who did not pay attention to the grading system,41(56.2%)said that they were willing to follow the grading system,and the remaining 32 patients were opposed.In the actual selection of patients for the first visit to the medical and health care institutions,162 people actually did the first diagnosis at the grassroots level.The proportion of these patients accounted for 54.0%,but 138 patients actually selected secondary and above medical institutions.The age,educational level,average monthly income,disease severity,type of participation,and accessibility of primary health care institutions in each of the influencing factors that led the patient to make the first choice of clinic were statistically significant(p<0.05).In the correlation test,there was no obvious correlation between the age of the patient and the choice of the first consultation institution.The other influencing factors were positively correlated with the initial diagnosis of the patient at the grassroots level except for the type of insurance.Two-class logistic regression analysis verified this rule again.The results were more rigorous and refined,removing the monthly income level of patients and the accessibility evaluation factors of some primary medical and health institutions.At the same time,the mechanism of influence on age and type of participation was made a detailed description.Conclusions and advice:The patient's understanding of the grading diagnosis and treatment system is still relatively shallow.Although there is a certain degree of enthusiasm for following the wishes,in the actual first choice of clinic,there is still a large proportion of patients who leave the primary clinic.Inadequate propaganda of the grading diagnosis and treatment system led to the lack of a strong mass basis;The medical security system and the grading diagnosis and treatment system still need to be further improved.The medical insurance system should exist in a form that helps promote the grading system.The accessibility of primary health care facilities needs to be further improved,and the ability and level of primary health care services must be strengthened to retain patients.The smooth implementation of the grading diagnosis and treatment system can not be separated from the joint efforts of the government,medical and health institutions and patients.The government should pay more attention to the improvement of the hierarchical medical treatment system and improve the implementation environment;medical and health institutions at all levels must strengthen their own construction and establish an effective communication and resource flow channels;patients should actively participate and actively cooperate.