社區民眾回診行為及影響因素探討

Factors Influencing the return-visit Rate for Referred Patients in a Community to Their Primary Care Clinics

林佩君(Pei-Jun Lin) ； 劉英琪(Ying-Chi Liu)

《台灣公共衛生雜誌》 29卷3期 (2010/06) Pp. 228-237

https://doi.org/10.6288/TJPH2010-29-03-06

摘要

目標：建構良好的分級轉診制度，有助於醫療資源作有效率配置。本研究旨在探討某社區基層診所轉診病患回診之影響因素，以提供雙向轉診制度政策之參考。方法：本研究針對台灣地區台中市之33個基層診所之轉診病患501名，訪員透過電話進行問春訪查，共回收有效樣本403份（有效回收率80.4%)，以sPssl40統計軟體進行邏輯斯迴歸分析。結果：研究結果發現雙向轉診制度實施後，基層診所轉診回診率為28.3%仍偏低，邏輯斯迴歸分析結果顯示病患以診所為習慣說醫地、病患之轉診目的為檢查或診斷、診所醫師囑咐回診以及受轉醫師囑咐回診，均有顯著較高之回診率。結論：由研究結果顯示，轉診病患回診的影響因素，除了轉診目的外，未來衛生政策規劃，若能積極推動家庭醫師制度，教育民眾以基層診所為習慣說醫地，且基層家庭醫師及受轉醫師均記得囑咐轉診病患回診，則可提高社區民眾之轉診回診率。

關鍵字

回診 ； 基層診 ； 基層醫師 ； 受轉醫師 ； 轉診回診率

並列摘要

Objectives: A well-constructed hierarchical medical care system makes effective use of medical facilities and resources. This study explores the factors influencing the return of a select group of referral patients to their primary care clinics in order to give the government constructive feedback for implementing an effective bi-directional referral system. Methods: The sample included five hundred and one referral patients chosen from thirty-three primary care clinics in Taichung, Taiwan. Data was collected by telephone interviews with 403 responders (a return rate of 80.4%). Logistic regression was used to determine the factors associated with return. Windows SPSS 14.0 was employed for analysis. Results: In the government's existing bi-directional referral system there was a relatively low return rate of 28.3% for referred patients. Results from logistic regression showed four primary reasons for returning: 1) patients opted for their original primary care physician out of habit; 2) the purpose of the referral was for testing or diagnosis; 3) these were the specific instructions of the referring physicians; 4) these were the specific instructions of the referred physicians. Of these, referral for testing or diagnosis was mentioned most often. Conclusions: In the future, public health policy could improve referred-patient return rates through patient and physician education. This should stress the value of using primary care and family clinic physicians and remind general practice clinic and hospital physicians to encourage referred patients to return to those primary care clinics.

並列關鍵字

return visit ； primary care clinics ； primary care physicians ； referral physicians ； return-visit rate

參考文獻

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