N市家庭医生服务签约居民服务利用现状及其影响因素研究

目的]了解N市签约居民对家庭医生服务的利用情况及其影响因素,为进一步推进家庭医生签约服务提供参考依据。方法]采用自制问卷,对该市10个辖区已签约家庭医生服务的共计29,947例居民进行电话调查,以有效问卷中的老年人或慢性病患者11,937例作为研究对象,调查其对家庭医生服务的认知情况,及对6项基本服务的利用情况,并对影响服务利用的因素进行回归分析。结果]知晓自己已签约的签约居民共7379人(61.8%),大部分知晓签约居民认为对服务包内容基本了解(64.1%);听心肺、抽血化验、做心电图、用药指导、血压监测和血糖监测6项基础服务利用率较高,都在75%以上,但仍存在"签而不约";不同性别、年龄、重点人群类别、知晓情况、城区的居民服务利用率差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,性别、重点人群分类、学历、是否知晓签约、是否主城区皆为服务利用率的影响因素。结论]N市签约居民服务利用率较高,性别、重点人群分类、学历、是否知晓签约、是否主城区是影响签约居民对家庭医生服务利用的影响因素。

Study on utilization of family doctor service contract and its influencing factors in N city

Objective To know the utilization of family doctor service contract and its influencing factors so that to provide reference for further promoting family doctor service contract. Methods It conducted telephone interview total of 29947 residents who had family doctor service contract in 10 districts and took 11937 elders or chronic diseases patients in valid questionnaire as research objects. It investigated awareness of family doctor service and the utilization of 6 items of basic service,conducted regression analysis on influence factors of service utilization.Results 7379( 61. 8%) residents knew that they had already signed family doctor service,64. 1% residents who basically understood service content. Utilization rates of 6 items basic services included cardiopulmonary examination,blood test,ECG,drug guidance,blood pressure and blood sugar monitoring were high which was over 75%,but part of residents signed with a family doctor but didn’t enjoy the service. There was statistical significance in the difference of urban residents’ service utilization ratio by gender,age,population classification and awareness( P < 0. 05). Multivariate logistic regression analysis found that gender,focus groups classification,education level,whether knew contract and lived in main urban area were the influence factors of service utilization ratio. Conclusions The service utilization rate of family doctor service contract is high in N city. Gender,focus groups classification,education level,whether know contract and live in main urban area are the influence factors of service utilization.