老年慢性病共存患者基层医疗机构首诊现状及影响因素研究

目的 了解老年慢性病共存患者基层医疗机构首诊现状及影响因素，为提高基层医疗机构患者首诊率及合理配置医疗资源提供建议。方法 采用便利抽样法，于2023年4—6月选取成都市金牛区、成华区、锦江区、新都区4个城区内517例社区老年慢性病共存患者作为研究对象，采用老年慢性病共存患者基层医疗机构首诊问卷进行调查。结果 517例老年慢性病共存患者中，39.3%在不适时倾向于选择基层医疗机构首诊；二元Logistic回归显示，性别、文化程度、户口所在地、婚姻状况、月收入水平、医疗保险、居住地到基层医疗机构距离、自评健康状况是老年慢性病共存患者选择基层医疗机构首诊的影响因素。结论 老年慢性病共存患者基层医疗机构首诊率低，受性别、婚姻状况、月收入水平等因素影响，基层医疗机构应强化医疗服务内容及水平，提供个性化服务，积极推动优秀资源共享和下沉，提高患者基层医疗机构首诊率。

A Study on the Current Situation and Influencing Factors of First Visit in Primary Medical Institutions for Elderly Chronic Disease Coexisting Patients

Objective To understand the current situation and influencing factors of the first consultation ofelderly patients with multiple chronic conditions in primary medical institutions,so as to provide suggestions forimproving the first consultation rate of patients in primary medical institutions and rational allocation of medicalresources.Methods From April to June,2023,a total of 517 community-dwelling elderly patients with multiplechronic conditions wereselected by convenient sampling method in Jinniu,Chenghua,Jinjiang and Xindu Districts ofChengdu.The questionnaire for the first consultation of elderly patients with multimorbidity in primary medicalinstitutions was used for the investigation.Results Among the 517 elderly patients with multimorbidity,39.3%tendedto choose primary medical institutions for the first consultation when they felt ill.Binary Logistic regression showed thatgender,education level,registered permanent residence,marital status,monthly income level,medical insurance,distancefrom residence to primary medical institutions and self-rated health status were the influencing factors for elderly patientswith multimorbidity to choose primary medical institutions for the first visit.Conclusion The first-visit rate of elderlypatients with multimorbidity in primary medical institutions is low,which is influenced by factors such as gender,marital status and monthly income level.Primary medical institutions should strengthen the content and level ofmedical services,provide personalized services,actively promote the sharing and sinking of excellent resources,andimprove the first-visit rate of patients in primary medical institutions.