CAJ | 학술논문

目的调查分析天津市社区卫生服务(CHS)机构就医患者对基本医疗服务的现状评价，并针对存在的问题提出对策及建议。方法分层抽取天津市6个中心城区的CHS中心与站各15家，随机拦截300例就诊患者进行问卷调查，了解其接受基本医疗服务情况与意向评价满意度。结果患病时首先选择到社区就诊的比例为52.3％ (157/300)，原因中第一位是离家近及方便，占89.2％ (140/157)；习惯找固定医生就诊者占25.3％ (76/300)。有17.7％ (53/300)患者不常看病。患者对医护人员服务能力与态度的综合满意度为78.7％，其中，对医生解释病情满意度最高，为83.7％ (251/300)；患者对医生疾病诊断、体格检查与辅助检查信任度均达92.0％以上。患者认为医生与其进行沟通交流的占87.0％ (261/300)，有85.0％ (255/300)的患者在就诊过程中得到过医生健康指导，82.0％ (246/300)患者认为医生注意了保护其个人隐私。患者对CHS机构服务环境设施与流程管理的综合满意度为73.6％，其中，药品种类、服务价格、仪器设备与服务环境的满意度均低于综合满意度。结论 CHS机构就诊患者对所接受的医疗服务基本满意；患者对CHS的利用不足；CHS机构的医疗服务能力需要提高。
목적 조사분석천진시사구위생복무(CHS)궤구취의환자대기본의료복무적현상평개，병침대존재적문제제출대책급건의。방법 분층추취천진시6개중심성구적CHS중심여참각15가，수궤란절300례취진환자진행문권조사，료해기접수기본의료복무정황여의향평개만의도。결과 환병시수선선택도사구취진적비례위52.3％ (157/300)，원인중제일위시리가근급방편，점89.2％ (140/157)；습관조고정의생취진자점25.3％ (76/300)。유17.7％ (53/300)환자불상간병。환자대의호인원복무능력여태도적종합만의도위78.7％，기중，대의생해석병정만의도최고，위83.7％ (251/300)；환자대의생질병진단、체격검사여보조검사신임도균체92.0％이상。환자인위의생여기진행구통교류적점87.0％ (261/300)，유85.0％ (255/300)적환자재취진과정중득도과의생건강지도，82.0％ (246/300)환자인위의생주의료보호기개인은사。환자대CHS궤구복무배경설시여류정관리적종합만의도위73.6％，기중，약품충류、복무개격、의기설비여복무배경적만의도균저우종합만의도。결론 CHS궤구취진환자대소접수적의료복무기본만의；환자대CHS적이용불족；CHS궤구적의료복무능력수요제고。
Objective To collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements. MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.Results Approximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.