ABSTRACT
Objective:To analyze the satisfaction of referral patients for the medical services provided by the countywide medical community, for reference in further improving its quality and continuity of medical services.Methods:From April to July 2021, a systematic sampling method was adopted to selected the survey subjects from the outpatients from the leading hospitals and three affiliated units of two medical communities, as well as those from two county-level hospitals of non medical communities and five grass-roots medical and health institutions. A total of 660 patients were included in the questionnaire survey. The questionnaire covered key demographic information and 15 satisfaction questions under 4 dimensions. The propensity score matching method was used to reduce confounding factors, factor analysis was used to calculate the satisfaction of referral patients in the medical community group and the non-medical community group, and the systematic dynamics approach was used to analyze the effect of patient satisfaction on referral intention.Results:A total of 641 valid questionnaires were collected. Based on a 1∶2 propensity score matching, 591 patients were finally enrolled, consisting of 102 up-referral cases from the non-community group and 273 such cases from the community group, as well as 76 down-referral cases from the non-community group and 140 such cases from the community group. The overall satisfaction scores by both up and down referral patients were 4.26(1.01)and 4.29(1.14)respectively.The overall satisfaction, medical service satisfaction, technical service quality satisfaction and non-technical service quality satisfaction of up-referral patients, as well as the overall satisfaction, non-technical service quality satisfaction of down-referral patients of the community group were higher than those from the non-community group, with differences statistically significant( P<0.05). The higher satisfaction of patients with their referral in the community, the stronger their referral willingness. Conclusions:The overall satisfaction of refrerral patients in the medical community group is higher than that of the non medical community group. The construction of county medical community has promoted the improvement of satisfaction of referral patients. However, it is still imperative to encourage high-quality medical resources to support primary institutions, to enhance the service level of primary medical and health institutions, to implement differentiated medical insurance reimbursement policies, and to improve the continuity of medical services within the community.
ABSTRACT
Objective To compare the Legionella contaminative status of the cooling water system with freezing water system in central air conditioning system. Methods Legionella was tested in water and samples of all components from the cooling tower, condenser, swelling water box and evaporator of central air conditioning among 26 public places. Results The total detected rate of Legionella was 64.0% among 100 samples from two kinds of water system, 71 strains of Pneumophila legionella were separated. The detected rates were 75.0% and 52.1% in the cooling water systems and freezing water systems respectively. The amount of Legionella was more than 100 per milliliter in the cooling water systems. The detection rate of cooling tower water and swelling water box water was 100% in the air conditioning system run for over 10 years and 5-10 years. Concordance rate of consequence was 50.0% in cooling tower water and condenser water of the cooling water systems, the rate was 55.0% in swelling water box water and evaporator water of the freezing water systems. Conclusion This study suggested that more attention should be paid to the contaminative status of Legionella in freezing water system of central air conditioning system. Cooling tower and swelling water box should be the key parts in cleaning and disinfection of air conditioning system.