三级医院医生向下转诊慢性期恢复期患者的意向及其影响因素分析

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Abstract Objective To analyze clinicians’ behavioral intentions and influencing factors of refer down to patients in the chronic recovery period. Methods From October 2018 to October 2019, the Questionnaire for Clinicians’ Referral Intentions in Tertiary Medical Institutions designed based on the theory of planned behavior was used to evaluate the results of oxght tertiary general hospitals in Xuzhou of Jiangsu Province, Hangzhou of Zhejiang Province, and Jining of Shandong Province. Clinicians conducted a cross-sectional survey and recovered 442 valid questionnaires. Pearson correlation was used to analyze the relationship between the doctor’s attitude toward referral patients, subjective norms, and perceptual behavior control influencing factors and the doctor’s refer down intention. Finally, a structural equation model was established to analyze the degree of influence of various factors on the doctor’s refer down intention and the influence path. Results 76.5% of the surveyed doctors had the intention to refer down patients in the chronic recovery period, among which, the intention of the senior professional title clinician was the highest, reaching 92.7%. There was a statistically significant difference in the referral intention of clinicians with different professional titles (P < 0.01). Attitudes, subjective behavioral norms, and perceived behavioral control had a direct impact on behavioral intentions, explaining 52%, 42%, and 23% of the differences in behavioral intentions. Attitudes had the greatest influence on intentions. Conclusion Attitude and subjective norms are the most important factors influencing the downward transfer intentions of clinicians in tertiary hospitals. Attitude has the greatest impact, followed by the social pressure that doctors feel from hospital deans, department directors, and colleagues, and patients and their families. The degree of support has little effect on the doctor’s transfer. In addition, the higher the degree of completeness of the transfer standard, the more convenient the medical insurance approval system, and the higher the proportion of doctors with high professional titles, the more favorable it is to promote the refer down of doctors to patients.

Key words： Doctors Refer down Theory of planned behavior Behavior intention Influencing factors

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	WANG Xia1
	2 DAI Tao2▲ HUANG Ju2

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WANG Xia1,2 DAI Tao2▲ HUANG Ju2. Analysis of the intention and influencing factors of doctors in tertiary hospitals to refer down patients in the chronic recovery period[J]. 中国医药导报, 2021, 18(17): 48-52,63.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I17/48

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