关键词: 分级诊疗, 认知, 影响因素分析, 居民, 河南

Abstract: Background　The deployment of hierarchical diagnosis and treatment policy has been comprehensively promoted by Henan provincial government.The level that hierarchical diagnosis and treatment policy implemented will directly determine the effect of the new healthcare reform.Precise understanding of the current status of residents' cognition of hierarchical medical system will be helpful in the promotion of the policy.Objective　To have a great understanding on the cognition level of residents for hierarchical medical system and to further explore its influencing factors in Henan Province.Methods According to researchers' family location，residents who were 16 years old or older with good communication levels and were willing to cooperate with the survey were selected as the respondents in 14 prefecture-level cities from Henan Province using convenient sampling method.A self-designed questionnaire was used to conduct the survey from November 2017 to March 2018.The main contents of the questionnaire were basic information of residents，residents' cognition to hierarchical medical system，suggestions on the implementation of the hierarchical medical system，and access to medical policy information.A total of 1 200 questionnaires were distributed and 1 137 valid questionnaires were returned with an effective recovery rate of 94.75%.Results　As for the hierarchical medical system，among 1 137 valid questionnaires，41（3.61%）residents chose "strong understanding"；141（12.40%）residents chose "clear understanding"；181（15.92%）residents chose "understanding"；542（47.67%）residents chose "little understanding"；232 （20.40%） residents chose "never heard of".The difference in the orthogonal comparison of diverse educational levels，types of registered permanent residence，and health care types among residents with different cognition levels of hierarchical medical system was statistically significant（P<0.05）．The results of binary Logistic regression analysis showed that the educational level and health care type were relevant factors affecting residents' cognition of hierarchical medical system（P<0.05）．The main ways for residents to gain medical policy information were broadcasting and television （59.19%，673/1 137）．Conclusion　Residents in Henan Province have insufficient understanding of the hierarchical medical system.It is proposed to further reinforce the promotion of hierarchical medical system and carry out personalized propaganda for residents in different situations ，so as to achieve the maximum publicity effect．

Key words: Hierarchical medical system, Cognition, Root cause analysis, Residents, Henan