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中文摘要: 目的：了解医联体成员单位医生对分级诊疗的认知评价，探究其影响因素，为促进医联体建设提供依据。方法：采用单纯随机抽样的方法，选取南京市儿童医院医联体模式下医联体单位的医生作为调查对象，采用儿科分级诊疗医生调查问卷，了解医联体单位医生对分级诊疗的评价与分级诊疗影响因素评价。结果：36.5%的人不太了解或很不了解分级诊疗政策，84.4%的人非常赞同或比较赞同实施分级诊疗制度，91.5%的人认为分级诊疗能缓解儿童“看病难、看病贵”问题，69%的人认为分级诊疗在引导患儿家长去基层卫生服务机构就诊的作用很大或有一定作用，59.7%的人认为分级诊疗对基层卫生服务机构的病源和医生的收入有影响。86.8%的人选择了偶尔或从未向上级医疗机构转诊过患儿，仅6.2%的人认为向上级医院转诊患儿非常通畅。政府、卫生行政部门推动分级诊疗的政策支持、政府用于分级诊疗政策的资金投入、政府宣传分级诊疗制度的力度等是影响分级诊疗的重要因素。结论：医务人员认可分级诊疗政策，但需加强政策宣传与引导；政府需加大对分级诊疗政策的支持力度与资金投入；发挥医保主导作用，建立激励机制；加强远程平台信息化建设。
Abstract:Objective：To understand the cognitive evaluation of doctors in medical alliance on hierarchical medical system，explore the influencing factors，and provide the basis for promoting the construction of hierarchical medical system. Methods：Using the method of simple random sampling，doctors of medical alliance in nanjing children’s hospital under the medical alliance mode were selected as survey objects，and questionnaires were used to investigate the evaluation and influencing factors of doctors of medical alliance. Results：36.5% of people didn’t understand or was not very understand the hierarchical medical system policy，84.4% of people strongly agree or quite agree for the implementation of the hierarchical medical system，91.5% of people thought hierarchical medical system could alleviate children problem of “difficulty and high cost of the doctor”，69% of people thought that hierarchical diagnosis and treatment play a great or certain role in guiding parents of children to go to primary health service institutions for treatment，59.7% of people thought that hierarchical diagnosis and treatment has an impact on the source of patients of primary health service institutions and the income of doctors. 86.8% of them selected occasional or never referrals to superior medical institutions，only 6.2% chose very unobstructed referrals to superior hospitals. The government and the health administration departments promoted the policy support of hierarchical medical system，the fund investment of the government for the hierarchical medical system policy，and the strength of the government’s publicity of the hierarchical medical system were the important factors influencing the hierarchical medical system. Conclusion：The medical personnel recognize the hierarchical medical system policy，but the policy need to strengthen the policy publicity and guidance.The government should increase the support and capital investment for the hierarchical medical system policy.It needs to give play to the leading role of medical insurance，establish incentive mechanism and strengthen the informatization of remote platforms.
keywords: hierarchical medical system medical alliance Cognitive evaluation Analysis of influencing factors
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基金项目:南京市卫健委一般性课题（YKK17158） 南京市卫健委一般性课题（YKK17158）
引用文本：
熊 婷,梁 慧,钱 昆?.儿科视角下医联体单位对分级诊疗的认知评价及影响因素分析△[J].江苏卫生事业管理,2020,31(8):983-986.
XIONG Ting,LIANG Hui,QIAN Kun?.Cognitive Evaluation and Influencing Factors Analysis of medical alliance units on hierarchical medical system from the perspective of pediatrics△[J].Jiangsu Health System Management,2020,31(8):983-986.
熊 婷,梁 慧,钱 昆?.儿科视角下医联体单位对分级诊疗的认知评价及影响因素分析△[J].江苏卫生事业管理,2020,31(8):983-986.
XIONG Ting,LIANG Hui,QIAN Kun?.Cognitive Evaluation and Influencing Factors Analysis of medical alliance units on hierarchical medical system from the perspective of pediatrics△[J].Jiangsu Health System Management,2020,31(8):983-986.
