县域医共体内患者持续就医行为双因素模型构建及验证研究OA

Objective To construct and validate a two-factor model of patients'continuous medical seeking behavior under the county-level hierarchical diagnosis and treatment system,and provide localized empirical evidence for optimizing primary medical services and promoting an orderly medical treatment pattern.Methods Based on customer satisfaction theory,a two-factor model of hierarchical collaboration-oriented technical competence and humanistic experience was constructed.A questionnaire was de-veloped,and convenient sampling was adopted to investigate patients in the county medical community.Structural equation model-ing(SEM)was used to conduct an empirical test with 349 valid questionnaires.Results Technical competence and humanistic ex-perience indirectly influenced the continuous medical seeking behavior through satisfaction and doctor-patient trust,with stand-ardized path βvalues ranging from 0.250 to 0.410 and 0.330 to 0.570,respectively.The smoothness of hierarchical referral had a significant effect on satisfaction(β=0.380),and hospital identity had the strongest directly driving effect on continuous medical seeking behavior(β=0.409),which was the core influencing factor.The model fit indices were satisfactory(χ2/df=2.454,GFI,AGFI,NFI,CFIall＞0.9,RMSEA=0.045).The scores of observed variables ranged from 3.52 to 4.38,indicating rea-sonable data distribution.Conclusion The quality of hierarchical linkage and local hospital identity are key to stabilizing patients'continuous medical seeking behavior in county areas.Taking technical collaboration as the foundation and emotional connection as the core,county medical communities can achieve the goal of treating serious illnesses within the county.