中青年楼宇白领人群家庭医生签约服务的个性化需求

背景　在健康中国政策的指导下,上海的家庭医生常住人口签约率超过45%。但是楼宇白领人群的家庭医生签约率较低,白领人群亚健康问题也愈发严峻。目的　了解目前楼宇白领人群对家庭医生签约服务的个性化需求,为上海市卫生系统制定相关政策措施提供理论依据。方法　于2019年8-9月采用多阶段抽样法选取上海市虹口区8个商务楼员工进行问卷调查。问卷内容包括基本信息、楼宇白领人群对家庭医生签约服务的需求及楼宇白领人群对家庭医生签约个性化服务包的需求3个部分。结果　共发放问卷1 040份,回收有效问卷993份,问卷有效回收率95.48%。家庭医生一般服务和楼宇服务“非常需要”排序第一的条目分别是代配药服务〔29.49%（253/858）〕和颈椎病等的防治〔36.37%（315/866）〕。63.30%（507/801）的楼宇白领人群对家庭医生签约个性化服务包有需求,不同文化程度、医疗保险投保情况楼宇白领人群对家庭医生签约个性化服务包需求情况比较,差异有统计学意义（P<0.05）。楼宇白领人群“最希望的”家庭医生签约个性化服务的开展方式、服务时间、价格区间分别为现场咨询〔26.53%（230/867）〕、工作午间1 h〔40.43%（399/987）〕、0~100元〔48.38%（417/862）〕。结论　楼宇白领人群具有个性化的健康管理需求,但缺乏便利可及的相应服务,建议设计针对白领的、形式多样的个性化有偿服务包,并给予政策支持。

Personalized Needs of Contracted Family Doctor Services in White-collar Workers Working in Office Buildings

Background　Against the backdrop of implementing the Healthy China 2030 initiative using the guideline issued by the state council,the contraction rate of family doctor services has exceeded 45% in Shanghai's general population,but it is lower in white-collar workers working in office buildings,a special group with increasing prevalence of serious sub-health problems. Objective　To investigate the personalized needs of contracted family doctor services in white-collar workers working in office buildings in Shanghai,to provide theoretical evidence for Shanghai's relevant health departments to develop health promotion policies targeting this group. Methods　Multi-stage sampling was performed to select employees working in 8 business office buildings in Hongkou District of Shanghai to attend a questionnaire survey from August to September 2019. The survey covered three parts: socio-demographic information,needs of contracted family doctor services,and of personalized service package delivered by family doctors. Results　A total of 1 040 cases attended the survey,and 993 of them（95.48%） who returned a responsive questionnaire were included finally. Among the options of "general medical services delivered by family doctors needed very much",the top one chosen by the respondents was proxy medication dispensing〔29.49%（253/858）〕. Of the options of "off building-based health services delivered by family doctors needed very much",the top one chosen was prevention and treatment of cervical spondylosis and other diseases〔36.37%（315/866）〕. 63.30%（507/801） of the respondents needed personalized service package delivered by family doctors. And such needs of them differed significantly by the level of education and medical insurance（P<0.05）. The "most expected" delivery pattern,delivery time and range of fee for personalized services provided by family doctors were on-site consultation〔26.53%（230/867）〕,1-hour midday break〔40.43 %（399/987）〕,and 0-100 yuan〔48.38%（417/862）〕,respectively. Conclusion　The white-collar workers have personalized demand for health management,but there is a lack of corresponding convenient and accessible services. It is recommended to develop various paid personalized service packages for them and to issue policies supporting the delivery.