居民首选社区卫生服务中心就诊情况及影响因素

目的了解四川省成都市居民首选社区卫生服务中心就诊情况及其影响因素,为当地社区卫生服务中心的发展提供参考依据。方法采用分层随机抽样方法在成都市6个主城区和6个郊区的12个社区卫生服务中心抽取6 902名≥18周岁常住居民进行问卷调查。结果调查的6 902名居民中,首选社区卫生服务中心、区医院及二级医院、个体诊所、三级综合医院及专科医院和其他类型医疗机构就诊的居民分别占25.31%、24.11%、18.89%、11.40%和20.28%;不同地区、性别、年龄、文化程度、家庭收入居民首选社区卫生服务中心就诊情况不同,差异均有统计学意义(P<0.000 1);参加社会医疗保险、知晓辖区内社区卫生服务中心、有慢性病患病和参加社区慢性病管理居民首选社区卫生服务中心就诊情况高于未参加社会医疗保险、不知晓辖区内社区卫生服务中心、无慢性病患病和未参加社区慢性病管理居民(P<0.000 1);多因素Logistic回归分析结果表明,居住在主城区、不知道家庭收入、参加社会医疗保险、知晓辖区内的社区卫生服务中心和参加社区慢性病患者管理的居民更愿意选择社区卫生服务中心作为首选医疗机构;初中及以上文化程度、家庭人均月收入≥3 000元和患有慢性疾病的居民不愿意选择社区卫生服务中心作为首选医疗机构。结论社区卫生服务中心是成都市城市居民首选就诊医疗机构;居住地区、文化程度、家庭收入、参加社会医疗保险情况、对辖区内社区卫生服务中心知晓情况、患有慢性疾病情况和参加社区慢性病管理情况是成都市居民选择社区卫生服务中心作为首选医疗机构的影响因素。

Medical attendance at community health service centre and its influential factors among urban residents in Chengdu city

Objective To investigate the medical attendance at community health service centre(CHS)and its influencing factors among urban residents in Chengdu city.Methods With stratified randomized sampling,6 902 urban people aged 18 years or older were selected from six urban and six suburban communities in Chengdu city in 2008.The information was collected with a face-to-face questionnaire interview.Results Among the residents,CHS became the first choice of medical attendance with a preference rate of 25.31%,followed by secondary grade hospital and district hospital(24.11%),individual clinic(18.89%),and third grade hospitals and special hospitals(11.40%).The preference rate for CHS was 38.90% in urban residents,11.47% in the suburban,22.70% among the males,27.20% among the females,26.56% among the residents with medical insurance,33.56% among the residents knowing the location of the CHS,29.85% among the residents suffering from non-communicable chronic disease,and 54.67% among the residents receiving medical service provided by the CHS,respectively.Logistic regression analysis results showed that the pro-factors for the preference of CHS included knowing the location of the CHS,living in urban area,receiving medical service provided by CHS,and having medical insurance and the inhibitive factors included with non-communicable disease,with higher family income,and with higher education level.Conclusion CHS became the first choice of medical attendance among the urban residents in Chengdu city.The influencing factors for the preference of CHS are living area,education level,average family income,medical insurance,with medical service provided by CHS,with knowledge of CHS,and with non-communicable chronic disease.