摘    要目的 通过对余杭区居民就医行为的调查，了解居民的就医行为并分析其影响因素，从而为卫生政策的制定提供良好依据。方法 采用定性与定量相结合的方法。根据分层整群抽样原则，随机抽取余杭区三个街道和三个乡镇进行问卷调查，采用卡方检验、秩和检验、二分类logistic回归分析等对所得资料进行统计分析。结果 本次调查一共发放了420份问卷，收回有效问卷406份，应答率为96。67%。余杭区居民两周患病率为15。3%，慢性病患病率为28。1%，住院率为10。6%。区级医院是人们首先考虑的就诊医院。年龄、职业、家庭平均月收入、城乡对最近一次就诊机构类型为基层还是非基层影响显著（P<0。05）；影响居民就医选择的主要因素包括年龄、家庭月收入、城乡（P<0。05）。基层医疗机构的候诊时间、医疗收费、服务态度满意度高于非基层医疗机构，而药品种类、医疗设备满意度则低于非基层医疗机构（P<0。05）。结论 18～30岁的居民选择基层就诊可能性低于31～45岁的居民。家庭平均月收入越高，基层就诊率越低。由此提出以下建议：落实基层医疗机构“健康守门人”责任，提高基层医疗技术水平，完善基本药物制度和医疗保险制度。89139

Abstract Objectives: Through investigating the medical behavior of residents in Yuhang district, the purpose of this study is to understand their choice of different medical institution of residents more deeply, and to analyze the factors that influence their medical behavior, the result is to provide a good foundation for the development of health policy。 Method: A combination of qualitative and quantitative methods was adopted。 According to the stratified cluster sampling principle, three streets and three towns of Yuhang district were randomly selected to conduct the investigation using questionnaire。 Chi square test, rank sum test and two classification logistic regression analysis were incorporated in the statistical analysis of collected data。 Result: A total of 420 questionnaires were distributed, and 406 of them were retrieved as valid questionnaires, with a response rate of 96。67%。 In general, the prevalence of being sick over a two-week period was 15。3%, and it was 28。1% for getting chronic diseases over the same time period, and the rate of hospitalization was 10。6%。 District level hospital is usually the first choice that residents will make。 Based on analyzing the single factor of the most recent medical behavior, age, occupation, average familial monthly income and whether urban or rural area greatly affect residents’ choice on different medical institutions (either the primary level or non-primary) (P<0。05); two logistic regression analysis has shown the main factors that influence residents’ selection of medical support include age, family income and whether living in urban or rural area (P<0。05)。 The satisfaction of waiting time, medical fees, service attitude to primary medical institutions was higher than that of non-primary medical institutions, The satisfaction of drugs, medical equipment to primary medical institutions is lower than that of non-primary medical institutions(P<0。05)。

Conclusion: Residents aged from 18-30 are less likely to choose primary level medical institutions for treatment and support compared to those aged from 31-45。 The higher the average familial monthly income, the lower the rate of visiting at the primary level medical institutions。 The following suggestions are drawn from the study: implement and emphasize the responsibility of "health gatekeeper" in the primary level medical institutions; improve the standard of primary medical technology; improve basic drug system and medical insurance system。

毕业论文关键词：就医行为；影响因素； 居民；余杭区