目的 了解上海市居民就医流向并提出政策建议。方法 采用随机分层抽样，选取上海市中心地区、城乡结合区和郊区各2个区，每个区在门诊部选取400名居民（医院和社区卫生服务中心各200人），在住院部选取200名居民（包括住院患者、该时间段内曾经在门诊就诊的陪同人员和未就医的陪同人员），共对3 600人进行问卷调查。问卷内容包括患者的基本资料、就诊时首选医院的级别以及选择该院就诊的原因。结果 回收有效问卷3 244份（90.1%）。门诊患者中，56.3%首选社区医院，34.0%首选三级医院；住院患者中38.3%首选社区医院，42.9%首选三级医院。门诊患者首选该院的原因：44.8%为就近方便，31.2%为医疗水平高，10.3%为服务态度好，5.2%为费用低；住院患者首选该院的原因：49.9%为医疗水平高，27.2%为就近方便，7.6%为服务态度好。结论 应尽快构建改善上海市居民就医状况和提高就医满意度的新型特色医疗卫生服务模式，完善医疗服务网络，建立两级医疗服务网络架构——区域医疗服务中心和基层医疗卫生机构。

Objective To investigate the hospitalizing intention of residents in Shanghai, and put forward policy suggestion. Methods Three thousand and six hundred residents were selected by random stratified sampling from 2 urban districts, 2 rural-urban fringe districrts and 2 suburban districts. Four hundred outpatients (200 from hospitals and 200 from community health centers) and 200 inpatients (from hospitals) were selected from each district for a questionnaire-based survey, which included basic information of patients, level of preferred hospital and reason for the choice of hospitals. Results A total of 3 244 questionnaires were recovered, with the recovery rate of 90.1%. For outpatients, 56.3% preferred community health centers, and 34.0% superior hospitals. For inpatients, 38.3% preferred community health centers, and 42.9% superior hospitals. For outpatients, 44.8% made the choice for close distance, 31.2% for high-quality medical care, 10.3% for friendly service, and 5.2% for low cost. For inpatients, 49.9% made the choice for high-quality medical care, 27.2% for close distance, and 7.6% for friendly service. Conclusion A new type of medical and health service delivery model should be constructed for residents in Shanghai. Much attention should be paid to the 2-level medical service system of regional medical service center and primary health care institution.