山东省农村居民对家庭医生签约服务认知水平及影响因素研究

目的了解山东省农村居民对家庭医生签约服务认知现况,探索认知相关影响因素,为进一步完善家庭医生签约制度提供实证依据。方法采用多阶段分层随机抽样,在山东省范围内按照经济水平随机抽取3个样本市作为研究地区,每个市各随机抽取2个县(区),每个县(区)随机抽取5个乡镇,每个乡镇随机抽取5个村,对样本居民进行面对面问卷调查,统计分析采用t检验、χ^2检验、二元Logistic回归等方法,探索居民对家庭医生签约服务认知的影响因素。结果2979例样本人群对家庭医生签约服务整体知晓率为44.3%,不同年龄、性别、婚姻状况、家庭年收入、饮酒状态、参加体育活动情况、自我医疗及两周患病对家庭医生签约制度的了解情况差异有统计学意义(P<0.05)。多因素分析结果显示,性别(OR=0.724,95%CI=0.587~0.893,P<0.01)、家庭年收入(Q3:OR=1.342,95%CI=1.064~1.692,P=0.013;Q4:OR=1.435,95%CI=1.127~1.827,P<0.01)、自评健康(不好:OR=0.689,95%CI=0.556~0.853,P<0.01;一般:OR=0.774,95%CI=0.624~0.889,P<0.01)、参加体育活动(OR=1.468,95%CI=1.262~1.707,P<0.01)和自我医疗(OR=1.240,95%CI=1.064~1.443,P<0.01)是农村居民对家庭医生签约服务认知的主要影响因素。结论山东省农村居民对家庭医生签约服务的认知水平有待进一步提高,性别、家庭年收入、自评健康、参加体育活动和自我医疗是影响农村居民家庭医生签约服务认知的主要因素,应针对政策认知薄弱人群进一步加强农村地区家庭医生签约服务的宣传力度。

Rural residents'knowledge of contracted family doctor services in Shandong Province and influencing factors

Objective To explore the status quo of rural residents'knowledge of contracted family doctor services in Shandong Province and its relevant factors,and to provide empirical evidence for contracted family doctor services system.Methods Multi-stage stratified random sampling was used to randomly select 3 sample cities in Shandong Province as the study sites according to economic level.Then,two counties(districts)were randomly selected from each city and 5 towns were selected from each county(district).Finally,5 villages were selected from each town.A face-to-face questionnaire survey was conducted among the sample residents.T-test,Chisquare test,and binary logistic regression were used to explore the influencing factors of residents'knowledge of contracted family doctor services.Results The overall awareness rate of 2979 respondents was 44.3%.There were statistically significant differences in age,gender,marital status,annual household income,drinking status,participation in sports activities,self-medication and two-week illness(P<0.05).Multivariate analysis results showed that gender(OR=0.724,95%CI=0.587~0.893,P<0.01),annual household income(Q3:OR=1.342,95%CI=1.064~1.692,P=0.013;Q4:OR=1.435,95%CI=1.127~1.827,P<0.01),self-reported health(Poor:OR=0.689,95%CI=0.556~0.853,P<0.01;Normal:OR=0.774,95%CI=0.624~0.889,P<0.01),participation in sports activities(OR=1.468,95%CI=1.262~1.707,P<0.01)and self-medication(OR=1.240,95%CI=1.064~1.443,P<0.01)were key factors affecting rural residents'knowledge of contracted family doctor services.Conclusions The knowledge of contracted family doctor services in rural residents of Shangdong Province needs to be further improved.The main influencing factors are gender,annual household income,self-reported health,participation in sports activities,and self-medication.Therefore,the publicity for contracted family doctor services in rural areas needs to be strengthened among populations who have poor knowledge.