福州城区家长对社区卫生机构及儿童医疗服务评价分析

目的了解福建省福州城区儿童家长对社区卫生机构与儿童医疗服务的评价及其影响因素。方法于2017年8—10月抽取福州城区936名14岁以下儿童家长为调查对象,运用logistic回归分析影响家长对儿童医疗服务满意度因素。结果儿童患常见病时,家长仍倾向于省市级医疗机构就诊,选择比例达68.06%;对于首选社区卫生机构为儿童常见病就诊机构的受访者,49.68%是出于交通或距离便利性的考虑,而出于就医成本或医保报销因素而选择社区卫生机构就诊的比例仅为19.50%;关于不选择社区卫生机构作为儿童首选就诊机构的原因,该部分人群中73.75%的受访者认为社区卫生机构儿童诊疗能力不足。儿童家长对儿童医疗服务的满意率仅为20.73%;有序logistic回归分析显示,儿童年龄介于1~3岁(OR=1.976,95%CI=1.089~3.585)、家庭年收入<8万元(OR=21.607,95%CI=6.758~69.081)、儿童健康状况良好及一般(OR=6.259、3.540,95%CI=2.561~15.299、1.512~8.287)是影响家长对儿童参保满意度的负面因素(P<0.05)。结论城区家长对社区卫生机构的信任不足,对儿童医疗服务的满意度不理想,影响满意度的主要因素包括儿童年龄、家庭年收入和儿童健康状况等。

Evaluations on community health institutions and pediatric services among parents of children under 14 years of age in urban Fuzhou

Objective To investigate evaluations on community health institutions and pediatric service and factors affecting the evaluations among the parents with children aged≤14 years in urban regions of Fuzhou city,Fujian province.Methods An on-site self-administered questionnaire survey was conducted among 1021 parents of children≤14 years old selected with convenient sampling in 3 urban districts of Fuzhou city of Fujian province between August and October 2017.Influencing factors of the parents'satisfaction to medical services to their children was explored with logistic regression analysis.Results Of the 936 respondents with valid information,68.06%reported the preference of selecting provincial or municipal medical institutions when their children suffering from common diseases.Of the respondents with the preference of visiting a community health institution for their children's common illness,49.68% reported the consideration of transportation convenience for the selection and only 19.50% reported the consideration of medical cost or medical insurance reimbursement;of the respondents not selecting community health institution service,73.75% considered that the community institution having no adequate capability on pediatric diagnosis and treatment.Only 20.73% of the respondents reported the satisfaction to the medical services to their children.Ordinal logistic regression analysis revealed following significant hindering factors for the satisfaction to medical insurance for children among the respondents:with a child aged 1-3 years(odds ratioOR]=1.976,95% confidence interval95%CI]:1.089-3.585),annual household income of less than 80000 yuan RMB(OR=21.607,95%CI:6.758-69.081),with a child in good or fair health(for good health:OR=6.259,95%CI:2.561-15.299,for fair health:OR=3.540,95%CI:1.512-8.287)(P<0.05 for all).Conclusion The parents of under 14 years children have a less confidence for pediatric diagnosis and treatment provided by community medical institutions and a low satisfaction to medical service for children and the satisfaction is influenced mainly by their children’s age,annual household income and children’s health condition.