The Study On The Responsiveness Of The Health System Of The Tertiary Hospitals In Guangzhou

ObjectiveTo understand the current situation of the responsiveness of the health system of the tertiary hospitals in Guangzhou,analyze the problems existing in the evaluation of the responsiveness of the residents of Guangzhou to the health system of the tertiary hospitals,and explore the influencing factors,so as to provide a scientific basis for further improving and improving the responsiveness of the health system of medical institutions,especially the tertiary public hospitals.SubjectIn this study,five hospitals(three general hospitals,one specialized hospital and one traditional Chinese medicine hospital)were selected from 15 tertiary hospitals affiliated to Guangzhou City,and then 100 inpatients were selected randomly from the five hospitals(one representative department was selected from internal and external paediatrics,and then 25 inpatients or family members were randomly selected from the departments)as quantitative research Research object.Random sampling method was used to select some inpatients,family members and medical staff from the third class A hospitals as the objects of qualitative study.MethodsField face-to-face survey of inpatients was carried out by using the questionnaire of health system responsiveness of key informed persons provided by WHO.Survey data were recorded by EpiData 3.1 software and logically checked.Statistics were calculated by Excel 2017 and SPSS21.Frequency,mean,standard deviation and composition ratio were used to carry out the survey.Descriptive analysis,unconditional logistic regression analysis was used to analyze the influencing factors,and descriptive analysis(percentage)was used to measure the distribution of responsiveness of health system.Descriptive analysis was used to evaluate patients' satisfaction.Results1?The level of responsiveness of Guangzhou' s tertiary hospitals is better than that of the national average.In terms of confidentiality,dignity and social support,the level of autonomy,selectivity and timeliness is relatively low.In addition,the quality of infrastructure,such as diet,medical environment,needs to be further improved and improved.2?Eight aspects of responsiveness of Guangzhou' s tertiary hospitals were evaluated:secrecy,dignity,social support,communication,autonomy,infrastructure quality and timeliness.3?Eight aspects of responsiveness of Guangzhou' s tertiary hospitals were ranked according to their importance:dignity,timeliness,confidentiality,communication,autonomy,selectivity,infrastructure quality and social support.4?The responsiveness scores of five tertiary hospitals in Guangzhou were from high to low,respectively,Guangzhou Women' s and Children' s Medical Center,Guangzhou Traditional Chinese Medicine Hospital,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou First People's Hospital and Guangzhou Twelfth People' s Hospital.5?Unconditional multivariate logistic regression analysis showed that the main factors affecting the items of evaluating dignity were gender,whether or not to purchase commercial insurance;the main factors affecting the items of evaluating autonomy were gender;the main factors affecting the items of evaluating communication were the situation of purchasing commercial insurance;and the main factors affecting the items of evaluating timeliness were age.The main factors affecting the evaluation of social support items are family per capita monthly income and whether to purchase commercial insurance;the main factors affecting the evaluation of infrastructure quality items are gender;the nature of household registration,employment status and whether or not to engage in medical services-related industries among family members are the evaluation options.The main factors affecting the overall responsiveness of the health system are gender.And the difference was statistically significant(p<0.05).6?The responsiveness distribution of Guangzhou' s tertiary hospitals was as follows:the proportion of the elderly(60 years old and above),the less educated(primary school and below),and the rural patients who were often unfairly treated was 10.44%,11.33%and 12.86%,respectively.7?Patient satisfaction survey results showed that patients were highly-satisfied with the overall hospital service,medical technology,service attitude and treatment effect(all more than 90%),and less satisfied with waiting time and medical expenses(less than 87%).8?Bivariate Logistic regression analysis showed that convenience of medical treatment,clear explanation of medical staff and medical expenses were the main factors affecting the overall satisfaction of medical services.9?Key insiders(patients,medical staff)interviews found that the responsiveness of municipal hospitals is generally good,but due to the inadequate infrastructure construction,service awareness and efficiency need to be further improved,and there is room for further improvement in eight aspects of responsiveness.Conclusion1?The responsiveness level of Guangzhou' s tertiary hospitals is generally good,but the quality and timeliness of infrastructure need to be further improved.2?Gender,age,per capita monthly income of families,the nature of household registration,employment status,whether to purchase commercial insurance and whether to engage in medical service-related industries among family members affect the health system responsiveness evaluation of municipal tertiary-hospitals in varying degrees.3?Key insider interviews found that patients,patients'families and medical staff have put forward feasible suggestions and suggestions on all aspects of the responsiveness of the municipal tertiary hospital health system.4?Age,education level and nationality are the main factors affecting the responsiveness distribution of tertiary hospitals in Guangzhou.5?In view of the present situation and influencing factors of the responsiveness of the health system in municipal tertiary hospitals,it is necessary to constantly adjust the allocation structure of health resources,strengthen infrastructure construction,strengthen communication between doctors and patients,improve information construction,optimize medical treatment process and respect patients' autonomous decision-making power,so as to improve the anti-health system in municipal tertiary hospitals.Adaptability.6?Guangzhou is a tertiary hospital with high quality of medical service,good service for medical staff and high patient satisfaction,all of which are more than 85.00%.