我国家庭医生签约服务利用现状及影响因素分析——基于全国31个省市的调查

目的：分析我国家庭医生签约服务利用现状及其影响因素。方法：对我国31个省（自治区、直辖市）的社区居民进行问卷调查，运用SPSS 25.0统计软件进行数据分析，采用Logistic回归模型探讨家庭医生签约服务利用现状的影响因素。结果及结论：居民对家庭医生签约服务的利用率偏低，不同特征人群利用签约服务的水平有差异。年龄、性别、户籍、文化程度、经济状况、卫生服务可及性是影响居民利用签约服务的重要因素；家庭医生签约服务利用情况的影响因素存在城乡差异，城市居民的签约服务利用情况更易受到地区因素的影响，而农村居民的签约服务利用情况更易受就业因素的影响。建议各地结合自身情况，完善家庭医生签约服务的政策设计，改善基层医疗卫生服务可及性，重点关注低收入人群和流动人口的签约服务，提高签约服务利用水平，推行有价值的家庭医生签约服务。

The current status of family doctors' contracting service utilization and its influencing factors: Based on a survey of 31 provinces and cities in China

Objective:To analyze the current status and influencing factors of family doctors'' contracting services utilization among community residents in China. Methods:A questionnaire survey was conducted among community residents in 31 provinces (Autonomous regions and Municipalities directly under the Central Government) in China, SPSS 25.0 statistical software was used for data analysis, and Logistic regression model was used to explore the factors affecting the utilization status of family doctors'' contracting services. Results and conclusions:The results showed a relatively low utilization rate of family doctors, and the contracting services utilization level varies with different groups or individuals'' characteristics. Age, gender, household registration, educational level, economic status, and access to health services are important factors that affect residents'' use of contracting services. The factors affecting the use of contracting services by family doctors showed significant differences between urban and rural areas, and urban residents'' use of contracting service was more vulnerable to regions, while rural residents'' use of contracting services was more susceptible to employment factors. It is suggested that each region should combine its situation, improve the policy design of family doctor contracting services and the accessibility of primary healthcare services, focus on contracting services for low-income groups and floating population, and promote valuable families doctor contracting service.