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分级诊疗背景下患者就诊医疗机构选择的研究进展
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Abstract:
患者就诊医疗机构具体流向是分级诊疗政策(以下简称“政策”)实施效果的重要体现，也是基层首诊和双向转诊制度落实情况的评价指标。多种分级诊疗模式的推广使得国内整体医疗资源的利用效率有所提升，但患者的实际就医行为与政策目标之间仍存在明显偏差。为此，众多学者展开了对影响患者就医行为的研究。这类研究站在医疗供给和需求的视角，试图识别出阻碍政策进一步落实的因素，从而提出相应的解决方案。本文梳理了患者就医选择的研究理论，概括了分级诊疗政策实施以来患者的就诊医疗机构选择情况及其影响因素，并揭露了已有研究中存在的研究内容和方法局限性与理论缺口，为进一步分析患者医疗机构选择驱动因素提供了新的研究思路。
The specific choice of patients to medical facility is an indicator of the effectiveness of the hierarchical medical system and a key performance indicator for evaluating the implementation of the primary care and two-way referral system. While the promotion of various hierarchical medical models has improved the overall efficiency of medical resource utilization in China, significant discrepancies remain between patients’ actual medical behavior and policy objectives. Consequently, numerous scholars have conducted research on factors influencing patient medical behavior. These studies, from the perspective of medical supply and demand, attempt to identify factors hindering further policy implementation and propose corresponding solutions. This paper reviews the research theories on patient health seeking decision, summarizes the patient choice of medical institutions and its influencing factors under the hierarchical medical system policy, and reveals the methodological limitations and theoretical gaps in existing research, providing new research ideas for further analysis of the driving factors of patient medical institution choice.
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