The Knowledge And Behavior Of Medical Risk On Investigation And Analysis In Grass-roots Health Workers Of Guizhou Province

Objective:To investigate and analyze the medical risk knowledge and behaviors of grass-roots health workers in Guizhou Province,to understand the medical risk management status of grass-roots health institutions in Guizhou Province,to analyze the main impacts of health risk knowledge and behaviors of grass-roots health workers in Guizhou Province,and provide reference to the management of medical risk for grass-roots health institutions,for better carrying out medical risk management to provide a scientific basis in grass-roots health institutions.Methods: Take the participants of health workers of township hospitals of Guizhou in 2016 as our research target.A simple random sampling method was used to select 1266 grass-roots health workers from 9 prefectures(cities,prefectures)in Guizhou Province and 1266 questionnaires were collected.The investigation includes the knowledge of the medical risk knowledge in grass-roots health workers,the awareness of health risks,and the impact of medical risk behaviors on medical disputes.Relative statistics(rates,percentages)were used for statistical description.the total score were obtained using the Likert five-point scale.The results were compared and analyzed by t test or analysis of variance test and linear trend chi-square test,The correlation analysis was performed,health risk behaviors were extracted by factor analysis of common factors,Using Structural equation model to study the influence of medical risk behavior on medical disputes.Results:(1)The average score of medical risk test was(47.44±15.96)and the qualified rate was 21.07%.The difference of scores among regional level of economic development,years of working experience,gender and age groups(P <0.01).Those with better economic development and shorter working years scored higher,The older the score,the lower,men score lower than women.Multivariate logistic regression analysis showed that gender and working years were the influencing factors of assessment on medical risk knowledge(P<0.05).(2)The overall score of medical risk awareness among primary health workers was(61.80±8.77)points.The difference of scores among years of working experience,age groups,job categories and gender.(P <0.05).Men's medical risk awareness score was higher than that of women,The object with longer working life and the older was the higher score.the GP scored lower than other health personnel.The chi-square test of the linear trend shows that with the increasing in the age and working years of grass-roots health workers in Guizhou Province,their awareness of medical risk has not increased along with it.Health personnel's medical risk awareness scores are related to gender,age,working years,and job positions,and are positively correlated with age and working years.Multivariate logistic regression analysis showed that gender,age,and working life were the influencing factors of medical risk awareness score(P<0.05).(3)Factor analysis results showed that the main factors reflecting medical risk behavior were hospital management,system implementation,and service attitude,risk awareness,medical quality,risk notification,job satisfaction,risk prevention measures and dispute handling methods;structural equation results show that The fitting effect of the model was good,The hospital management was of the greatest impact to medical dispute,internal factors was of next,system implementation and job satisfaction were of weaker effect(the total utility were 0.4328,0.42,0.2876,0.1596 respectively),The internal factors were mediator variables,which included service attitude,risk awareness,medical quality,risk notification,risk prevention measures and dispute settlement.Conclusions:(1)The recognition of medical risk knowledge was insufficient at the grass-roots health workers;With the increasing of age and working years,the awareness of medical risk has not increased along with it among grass-roots health workers;(2)It is suggested that the learning and understanding should be further strengthened about medical risks of primary health workers on legal knowledge,the medical risk awareness of health personnel should be strengthen,by purchasing medical risk insurance transfer medical risk,and focusing on the establishment of a new mechanism for the treatment of medical disputes by “specialized departments and professional personnel”.At the same time,the management department should strengthen the financial investment in grass-roots health services,focus on improving the management the management of basic medical institutions,strengthen the internal management of medical risks,strictly implement the medical rules and regulations,and enhance the job satisfaction of primary health workers so as to increase the management level of risk on grass-roots health institutions for prevention and controlling medical disputes.