| Objective:China’s first community care system began in 2006,has been carried out for exceed ten years.It is important to establish a community first diagnosis system,through this system can reasonably triage patients,improve the utilization of health resources,improve the new health service system,improve the health level of residents,to lay a solid foundation for building a harmonious society of health.The purpose of this study is to understand the operation of the first treatment in the community,the existing problems;to investigate the residents awareness,to accept the first diagnosis system the degree of satisfaction and seeking behavior,and further understand the influencing factors of the implementation of the first treatment in the community,so as to put forward policy suggestions of Italy,to provide reference basis for the improvement of Xi’an city community first diagnosis.Methods:This study is based on the present situation of the first consultation of community health service center in Xi’an city,in part to the community as a research field,mainly by the method of literature research and in-depth interviews,classification of diagnosis and treatment at home and abroad development situation and running situation of Xi’an community first option system background analysis;The survey of 600 residents in some parts of Xi’an city was carried out by questionnaire,received valid questionnaires 550 copies,and the data were collected and analyzed in statistical analysis.Case introduced method,through to the community health service center,learn more about Xi’an residents demand,community medical institutions the allocation of resources,and operations.Result:The results show: according to the current situation of the development of domestic and international community first diagnosis system and system of the first treatment in the community of Xi’an City,the residents of the ifrst poorer awareness and acceptability,satisfaction and awareness through the chi square test showed residents age,marital status,education,occupation,personal annual income,home to the community hospital distance for the first treatment in the community have influence;grassroots doctors less education,grassroots doctors less experience,equipment can not meet the requirements of the first treatment in the community and can not meet the common disease / drug effects in the satisfaction of the first treatment in the community;that cultural degree,whether or not to purchase commercial insurance and to know whether the first treatment in the community and the first treatment in the community hospital distance for the first treatment in the community acceptance effect 1ogistic regression;and the first treatment in the community propaganda,The doctor’s diagnosis and treatment level and the distance to the community hospital,the residents of the first selection of the medical and health institutions.Conclusion:The study found that the community first diagnosis system has been a problem,although it has achieved some results,but still arduous task.The specific problem is: the lack of government functions,the first treatment in the community of thinking is not clear;the leverage of medical insurance play;the compensation mechanism of medical institutions are not perfect;irrational allocation of resources,weak infrastructure;general practitioners lack of staff,medical and technical level is uneven;the basic community health service form,management system the concept of health is not perfect;residents need to change;to guide the residents’ behavior of health care;residents need to improve the trust crisis.Suggestion:Strengthen government functions and increase policy guidance;To establish a normative system for effective operation;Improve the publicity and set up the correct view of medical care;To improve the training and use of community health personnel;We will improve the system of medical insurance and make full use of leverage.We will clarify the orientation of community medical care and improve the service. |
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