摘要
目的了解浙江省18~25岁人群基层医疗机构就诊意向和卫生服务满意度,并分析影响因素,为提升基层医疗机构卫生服务质量提供依据。方法于2019年11—12月采用"问卷星"制作电子问卷并通过微信推送,调查浙江省18~25岁人群的基本情况、基层医疗机构就诊意向和卫生服务满意度。采用Logistic回归模型分析基层医疗机构就诊意向和卫生服务满意度的影响因素,采用重要性矩阵分析基层医疗机构卫生服务满意度的关键驱动因素。结果共发放问卷664份,有效问卷620份,有效率为93.37%。有基层医疗机构就诊意向142人,占22.90%。过去一年有基层医疗机构就诊经历516人,占83.23%;其中对基层医疗机构卫生服务感到满意和很满意384人,占74.42%。多因素Logistic回归分析结果显示,参与新型农村合作医疗保险(OR=3.062,95%CI:1.745~5.373)和在社区(村)卫生服务中心(站)有健康档案(OR=0.547,95%CI:0.308~0.970)是18~25岁人群基层医疗机构就诊意向的影响因素;医生的技术水平(OR=1.478,95%CI:1.168~1.871)、医护人员药物告知情况(OR=1.308,95%CI:1.065~1.606)、常规项目检查(OR=1.523,95%CI:1.227~1.889)、支付方式(OR=1.168,95%CI:1.017~1.340)、就医环境舒适性(OR=1.785,95%CI:1.437~2.219)和卫生知识宣传栏(OR=1.302,95%CI:1.086~1.561)是18~25岁人群基层医疗机构卫生服务满意度的影响因素。重要性矩阵分析结果显示,"常规项目检查"和"医生的技术水平"位于优先改进区;"就医环境舒适性"位于竞争优势区;"医护人员药物告知情况"位于次要改进区;"支付方式"和"卫生知识宣传栏"位于有待分析区。结论浙江省18~25岁人群基层医疗机构就诊意向较低,就诊意向受社区(村)卫生服务中心(站)有无健康档案和社会医疗保险类型的影响;但对基层医疗机构卫生服务较为满意,医生的技术水平和常规项目检查是基层医疗机构卫生服务满意度的关键驱动因素。
Objective To analyze the status and influencing factors of the intention of people aged 18 to 25 years toprimary medical institutions and their satisfaction for health services in Zhejiang Province, so as to provide basis for the improvement of health services in primary medical institutions.Methods During November and December in 2019,the 18-25 year-old people in Zhejiang Province were recruited to investigate the general information, intention to seekmedical advice and satisfaction for health services in primary medical institutions through WeChat. Logistic regressionwas performed to analyze the influencing factors of the intention and the satisfaction. Importance matrix was used toanalyze the key drivers of the satisfaction.Results Among the 620 people surveyed, with a response rate of 93.37%,142( 22.90%) chose primary medical institutions for advice. Actually 516( 83.23%) people went to primary medical institutionslast year, and 384( 74.42%) of them were satisfied with the health services. The results of multivariate logistic regressionanalysis showed that the people aged 18-25 years who were under the new rural cooperative medical care system( OR=3.062, 95%CI: 1.745-5.373) and who had records in community health centers( OR=0.547, 95%CI: 0.308-0.970) weremore likely to go to primary medical institutions for medical advice;the ability of doctors( OR=1.478, 95%CI:1.168-1.871),the drug notification by medical staff( OR=1.308, 95%CI: 1.065-1.606), routine examination items( OR=1.523,95%CI: 1.227-1.889), the ways of payment( OR=1.168, 95%CI: 1.017-1.340), the comfort of environment( OR=1.785,95%CI: 1.437-2.219) and the bulletin boards of health knowledge( OR=1.302, 95%CI: 1.086-1.561) were associated withthe satisfaction. The results of importance matrix analysis showed that the ability of doctors and routine examinationitems were the priorities to improve, followed by the drug notification by medical staff;the comfort of environment hadcompetitive advantages;the ways of payment and the bulletin boards of health knowledge needed to be further analyzed.Conclusion sThe 18-25-year-old people in Zhejiang Province were less intended to seek medical advice in primarymedical institutions, which was associated with the type of medical insurance and records in community health centers.They were satisfied with the health services, the ability of doctors and routine examination items were the key drivers.
作者
徐韵涵
潘佳豪
何雨飒
叶炳琪
谢任翔
吐尼沙古丽·买合木提
徐锌
王迪娜
王道森
俞林杰
陈民和
严若晨
薛可欣
付雅静
叶怀庄
吴息凤
李秀央
XU Yunhan;PAN Jiahao;HE Yusa;YE Bingqi;XIE Renxiang;MAIHEMUTI Tunishaguli;XU Xin;WANG Dina;WANG Daosen;YU Linjie;CHEN Minhe;YAN Ruochen;XUE Kexin;FU Yajing;YE Huaizhuang;WU Xifeng;LI Xiuyang(School of Medicine,Zhejiang University,Hangzhou,Zhejiang 310058,China;不详)
出处
《预防医学》
2020年第8期767-773,共7页
CHINA PREVENTIVE MEDICINE JOURNAL
基金
浙江省大学生科技创新活动计划(新苗人才计划)项目(2020R401093)。
关键词
基层医疗机构
就诊意向
满意度
关键驱动因素
primary medical institutions
intention to seek medical advice
satisfaction
key driver
