中国卫生产业
CHINA HEALTH
INDUSTRY
[基金项目]浙江省哲学社会科学规划课题(16NDYD03YB)；浙江省社科规划“社会重大舆情调研”专项课题(项目编号:16YQDY06YB)；温州市公益性科技计划软科学研究项目(项目
编号:R20160015)。
[作者简介]吴素君(1981-)，女，浙江温州人，博士在读，讲师，研究方向：医学管理及文化研究。
2014年，浙江省卫生计生委将温州列入全省分级诊
疗试点地区，温州市政府随即出台了《温州市分级诊疗试点工作实施方案》，标志着温州市分级诊疗试点工作正
式启动。2014年10月底，浙江省启动分级诊疗试点。同年12月底，温州市、绍兴市作为市级试点对象，
在全市范围内启动试点。该文旨在通过对温州市分级诊疗试点的调研，梳理当前分级诊疗工作的进展情况、存在问题，进而提出建议。报道如下。1资料与方法1.1一般资料
研究对象为就医者、县级以上医院医务人员、基层医疗机构医务人员。2015年6月，发放调查问卷800份,
DOI:10.ki.1672-5654.2019.22.011
浙江省温州市分级诊疗实施现况及对策研究
吴素君
温州医科大学，浙江温州
325035
[摘要]目的了解温州市分级诊疗实施现状，为分级诊疗制度完善提供参考依据。方法以《温州统计年鉴》等数据为基础，通过整群抽样，向就医群众，县级以上医疗机构医务人员，基层医疗机构医务人员发放调查问卷800份，描述性分析分级诊疗知晓率与执行情况、影响分级诊疗的因素、基层医疗机构工作人员薪酬满意度等。结果就医群众不了解分级诊疗制度达64.3%，基层医务人员和县级以上医
院医务人员对分级诊疗政策的了解率分别是49.7%和48.7%。基层医疗机构工作人员认为机制不健全和患者不信任基层医疗机构的医疗技术水平是影响分级诊疗的主要原因分别占56.1%和66.8%；基层医务人员认为其劳动价值能在薪酬上体现仅占37.4%。结论分级诊疗相关制度不完善，基层医疗机构承接力不足，县级以上医疗机构推动分级诊疗意愿不强是当前分级诊疗实施过程中存在的主要困难。[关键词]温州市；分级诊疗；实施现况；对策[中图分类号]R19
[文献标识码]A
[文章编号]1672-5654(2019)08(a)-0011-04
Current Status and Countermeasures of Graded Diagnosis and Treatment in Wenzhou City,Zhejiang Province
WU Su-jun
Wenzhou Medical University,Wenzhou,Zhejiang Province,325035China
[Abstract]Objective To understand the status quo of the implementation of grading diagnosis and treatment in Wenzhou City,and provide reference for the improvement of grading diagnosis and treatment system.Methods Bad on the data of Wenzhou Statistical Yearbook and other data,800q
uestionnaires were distributed to medical personnel,medical staff at medical institutions at or above the county level,and medical staff at primary health care institutions,descriptive analysis of graded diagnosis and treatment awareness rate and implementation situation,factors affecting graded diagnosis and treat⁃
ment,and salary satisfaction of staff in primary medical institutions.Results The medical treatment people did not under⁃stand the graded diagnosis and treatment system reached 64.3%.The understanding rate of the medical treatment staff of the grassroots medical staff and the hospitals above the county level was 49.7%and 48.7%,respectively.The staff of the
primary medical institutions think that the mechanism is not perfect and the patients do not trust the medical technology level of the primary medical institutions,which is the main reason that affects the graded diagnosis and treatment,account⁃ing for 56.1%and 66.8%respectively;the grassroots medical staff thinks that the labor value can only account for 37.4%in
the salary.Conclusion The system of grading diagnosis and treatment is imperfect,the undergraduate medical institutions
have insufficient capacity,and the medical institutions at or above the county level are not strong in pr
omoting the grading diagnosis and treatment.This is the main difficulty in the current implementation of grading diagnosis and treatment.[Key words]Wenzhou City;Graded diagnosis and treatment;Implementation status;Countermeasures
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