通讯作者: 王颖, yingwang_2016@163.com

DOI：10.12201/bmr.202107.00024

Study on the influence of patients trust mode and level on the willingness of primary first visit

• 摘要：目的 分析和调查患者对基层卫生机构的信任模式和水平，探索其对基层首诊意愿的影响。方法 采用多阶段抽样和方便抽样，选择山东省青岛市、东营市、枣庄市12区县的38家基层卫生机构，问卷调查当日前去就医的患者和附近居民，总计调查676人。结果 64.4%的患者总体上信任基层卫生机构，人际信任（80.3%）高于体系信任（48.6%）。有明确基层首诊意愿的患者比例为60.4%，年轻、高学历人群的基层首诊意愿相对更低。多元线性回归结果表明，体系信任和人际信任可通过总体信任的中介作用影响基层首诊意愿，体系信任的回归系数比人际信任更大。结论 患者对基层卫生机构的人际信任高于体系信任，但影响其总体信任和基层首诊意愿的首要因素是体系信任。当前亟需提升基层医疗水平从而增强患者的体系信任，并借助家庭医生签约服务提质增效的改革契机巩固和突显基层人际信任的比较优势，从而促进分级诊疗目标的实现。

  关键词： 患者信任水平；人际信任；体系信任；基层首诊意愿；分级诊疗; ; ; ; 

   

  Abstract: Objective To analyze and investigate the mode and level of patients trust in primary health institutions, and explore its effect on the willingness of primary first visit. Methods Multistage sampling and convenience sampling were used and 38 primary health institutions in 12 districts and counties of Qingdao, Dongying and Zaozhuang in Shandong province were selected to conduct a questionnaire survey on the patients who went to hospital on that day and nearby residents. A total of 676 people were investigated. Results 64.4% of the patients trusted primary health institutions, and interpersonal trust (80.3%) was higher than system trust (48.6%). The proportion of patients with clear willingness of primary first visit was 60.4%, and the willingness of young and well-educated people was relatively lower. The results of multiple linear regression showed that system trust and interpersonal trust could mediate the willingness of primary first visit through the overall trust, while the coefficient of system trust was larger than that of interpersonal trust. Conclusion The level of interpersonal trust in primary health institutions is higher than that of system trust, but the primary factor affecting overall trust and the willingness of primary first visit is system trust. At present, it is urgent to improve the level of primary medical service to enhance the system trust in primary health institutions, and consolidate as well as highlight the comparative advantages of interpersonal trust of primary health institutions by taking advantage of the reform of the contract of family doctor services which is improving the quality and efficiency, so as to promote the realization of the goal of hierarchical diagnosis and treatment.

  Key words: Patient’s Trust Level; Interpersonal Trust; System Trust; Willingness of Primary First Visit; Hierarchical Diagnosis and Treatment

  提交时间：2021-10-08

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• 序号	提交日期	编号	操作
  1	2021-07-04	bmr.202107.00024V1	下载

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