| Objective(1)To investigate the service utilization of gastrointestinal examination in outpatients of the Department of Gastroenterology;(2)To analyze the service utilization of influencing factors of gastrointestinal examination for patients;(3)To analyze the person times and cost of gastrointestinal examinations in a hospital;(4)To propose intervention measures for the service utilization of gastrointestinal examination in patients.Methods(1)Naval Anqing Hospital,Tongcheng People’s Hospital and Hanshan People’s Hospital in Anhui Province were selected as the investigation and observation sites;(2)Investigate and observe the patients who came to the outpatient department of gastroenterology for gastrointestinal reasons;(3)Statistical analysis was conducted on the survey data using SPSS19.0 software,and the descriptive analysis,chi-square test and Logistic regression analysis were used for statistical analysis.Results(1)A total of 725 outpatients in gastroenterology department were investigated,the average age was(50.70±14.56)years old.The number of male(51.7%)was more than the female(48.3%),the primary school education accounted for 30.9%,married accounted for 77.5%,52.8% of them had normal BMI,and 42.8% of them had high blood pressure.(2)58.1% of people had endoscopic examination,44.7% of them had done it once,and 43.0% of them had endoscopic examination within 6 months.Binary logistic regression results showed that gender,age,marital status,history of digestive tract,gastrointestinal medicine history is the influence factors of endoscopy for patients.Ordinal logistic regression results showed that gender,age,marital status,history of digestive tract,gastrointestinal medicine history is the influence factors of endoscopic inspections for patients.(3)32.8% of the people had helicobacter pylori test,64.7% of them had done it once,54.2% of those had helicobacter pylori test within 6 months.Binary logistic regression results show that the degree of cultural history,often symptoms of digestive tract,the digestive tract,gastrointestinal medicine history is the influence factors of helicobacter pylori test for patients.Ordinal logistic regression results show that the degree of culture,history of symptoms of digestive tract,the digestive tract is often the influence factors of helicobacter pylori test for patients.(4)64.4% of the people had abdominal ultrasound,40.6% of them had done it once,48.3%of those had abdominal ultrasound within six months.Binary logistic regression results showed that age,culture level,history of digestive tract,gastrointestinal medicine history is the influence factors of abdominal ultrasound examination for patients.Ordinal logistic regression results showed that age,culture level,BMI,history of digestive tract,gastrointestinal medicine history is influence factors of abdominal ultrasound for patients.(5)28.6% of people had abdominal CT,63.6% of them had done it once,51.5% of those had abdominal CT within six months.Logistic regression results showed that gender,age,cultural degree,marital status,BMI,blood pressure,often symptoms of digestive tract,the digestive tract,medical history,history of gastrointestinal medicine,history of drinking,smoking,pollution history,family history of cancer is not the influence factors of abdominal CT for patient.(6)27.6% of people had stool routine examination,56.5% of them had done it once,36.0% of those had stool routine examination within six months.Binary logistic regression results showed that the digestive tract medical history,history of pollution influence factors of stool routine inspection for patients.Ordinal logistic regression results showed that BMI history,history of digestive tract,pollution is the influence factors of stool routine inspections for patient.(7)13.8% of people had barium meal examination,80.0% of them had done it once,30.0% of those had barium meal examination within six months,binary logistic regression results showed that age,history of digestive tract is the influence factors of barium meal examination,ordinal logistic regression results showed that age,culture level,history of digestive tract,history of drinking is the influence factors of barium meal examination number.(8)A total of 607 people were observed,32.4% and 14.5% of the patients who had ever have endoscopy and abdominal ultrasound underwent endoscopy and abdominal B-ultrasound again within 6 months,but 27.6% and 69.1% of the patients who did not do endoscopy and abdominal ultrasound examination in the last three years or more.Stomachache,abnormal stool and examination history were the influencing factors of endoscopy for patients.Stomachache,unsmooth swallowing,foreign body sensation,nausea and vomiting,abdominal pain,diarrhea,and examination history are the influencing factors of abdominal ultrasound for patients.(9)There were a total of 6727 person times of people who visits to the Department of Gastroenterology in a hospital from January to November,among which gastroscopy had the highest number of visits(52.9%)and the highest proportion of expenses(33.5%),while gastrointestinal angiography had the least number of visits(0.4%)and the lowest proportion of expenses(0.3%).(10)The Intervention measures includes: paying attention to the characteristics of patients,regularly participating in gastrointestinal examination,reducing excessive gastrointestinal examination,and paying attention to the influencing factors.Conclusion(1)Outpatients in the Department of Gastroenterology are generally older and less educated.(2)The utilization of gastrointestinal examination services differs greatly among patients.Some patients have underwent many gastrointestinal examinations,and some patients had a long time since the last gastrointestinal examination.(3)Different demographic characteristics have different effects on the utilization of gastrointestinal examination;Patients with gastrointestinal symptoms,a history of gastrointestinal symptoms,and a history of gastrointestinal medication were more likely to have had a endoscopic examination,but more patients with these characteristics had never had a endoscopic examination.(4)The use of gastrointestinal examination in outpatients of the Department of Gastroenterology was not standardized.Many patients have not been examined for a long time,and many patients have been examined multiple times within a short time.(5)Gastrointestinal endoscopy should be an important examination item for outpatients in gastroenterology department.(6)This study proposed intervention measures based on the health belief model,which can help to improve the patients’ cognition of examination,participate in the examination regularly,reduce the over examination,and promote the standardization of gastrointestinal examination. |
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