上海市家庭医生制度的实施进展与发展瓶颈

  目的  分析比较山东省城乡居民对于家庭医生签约服务认知与利用情况的差异性。  方法  于2017年以山东省为研究现场，采用多阶段分层抽样方法，共随机抽取1 200名社区居民为调查对象。根据研究目的、文献梳理和专家咨询等设计问卷；采用调查员面对面访问收集资料；采用Epi Data 3.1建立数据库。采用SPSS 17.0统计软件进行数据清洗和分析。  结果  共回收1 052份有效问卷，城市居民对家庭医生签约服务的知晓率（70.3 %）低于农村（92.1 %），完全不了解家庭医生签约服务的内容有城市社区居民（93人，30.4 %）高于农村（77人，10.3 %），城市居民在首诊选择社区卫生服务机构（46.7 %）、上门服务（63.7 %）、随访电话（62.4 %）的利用也分别低于农村（85.8 %，88.2 %，77.6 %），差异均有统计学意义（P < 0.05）。  结论  城市居民对家庭医生签约服务的认知和利用程度低于农村居民，具有一定的差异性。

The European primary care monitor: structure,process and outcome indicators

  Objective  To explore the situation on recognition and utilization of contracted family doctor services among residents in Shandong province and to compare differences in the recognition and utilization between urban and rural residents.  Methods  With stratified multi-stage random sampling, we conducted face-to-face interviews among 1 200 residents aged 18 years and above in urban communities or rural villages in three municipalities of Shandong province in 2017. We compiled a questionnaire for the survey based literature review and expert consultation. Epi Data 3.1 and SPSS 17.0 statistical software were adopted in data processing and analyses.  Results  A total of 1 052 valid questionnaires were collected. Compared to that among the rural residents, the awareness rate of contracted family doctor service was lower among the urban residents (70.3% vs. 92.1%) but the proportion of knowing nothing about the items of the services was higher among the urban residents than that of rural residents (30.4% [93 people] vs. 10.3% [77 people]). The urban residents also reported significantly lower ratios of selecting community healthcare institutions when visiting a doctor at first (46.7% vs. 85.8% ), utilizing on-site service (63.7% vs. 88.2%), and receiving telephone follow-up (62.4% vs. 77.6% ) in comparison to the rural residents (P < 0.05 for all).  Conclusion  The awareness and utilization of contracted family doctor service are lower among urban residents than those among rural residents in Shandong province.