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目的了解社区居民出现流感样症状首次就诊情况,探讨影响流感样病例选择基层医疗机构作为首诊医院的相关因素,为进一步做好基层医院首诊工作、推进双向转诊提供依据。方法选择深圳市龙岗区第四人民医院就诊的部分流感样病例作为研究对象,对患者的就诊特点等相关情况进行问卷调查。结果 600例流感样病例患者中,首先选择前往县区及以下医疗机构者就诊者仅有232例,占比38.67%。多因素logistic回归分析结果显示,就诊意愿(OR=3.900,95%CI=2.319~6.535)、交通方式(OR=4.666 4,95%CI=2.049~10.282)、候诊时间(OR=2.132,95%CI=1.352~3.356)是影响患者选择基层医院作为首诊医疗机构的主要因素。结论该区流感样病例首诊选择基层医院的就诊率不高,应进一步增强患者的就诊意愿、加强基层医疗服务的便捷性和可及性等,提高患者基层医院首诊就诊率。
Objective To understand the first visit of flu-like symptoms in community residents and to explore the factors influencing the choice of grass-roots medical institutions as first-line hospitals in flu-like cases so as to provide the basis for further conducting the first visit to primary hospitals and promoting two-way referral. Methods Select some flu-like cases treated by the Fourth People’s Hospital of Longgang District of Shenzhen as the research object, and conduct questionnaire survey on the characteristics of the patients’ visits and so on. Results Among the 600 cases of influenza-like illness, only 232 cases were selected to go to the county and the following medical institutions, accounting for 38.67%. Multivariate logistic regression analysis showed that the waiting time (OR = 2.132, 95% CI, CI = 1.352 ~ 3.356) is the main factor influencing patients to choose primary hospitals as the first medical institution. Conclusion The first visit of influenza-like illness in this area is not high in primary hospitals. The willingness to seek medical attention should be further strengthened and the convenience and accessibility of primary medical services should be strengthened so as to improve the first visit rate of patients in primary hospitals.