摘要
目的:分析山东省社区居民对家庭医生签约服务的评价状况及其签约意愿影响因素,为进一步提高家庭医生签约服务项目的服务质量,提高居民签约率提供参考。方法:选取山东省6个地区的618名社区居民进行问卷调查,并对数据进行描述性统计分析、单因素分析和二分类logistic回归分析。结果:在服务项目上,社区居民认为家庭医生签约服务满足需求项目排在前3位的为健康体检(89.3%)、常见病诊疗(86.8%)、慢性病筛查(85.0%)。在满意度评价中,居民对就医便捷性最满意,对医疗设备最不满意。回归分析结果显示,慢性病选择医疗机构、是否知晓分级诊疗、是否支持家庭医生签约服务、首诊选择基层医疗机构的意愿、对家庭医生的信任度是影响家庭医生签约意愿的因素(P<0.05)。结论:山东省社区居民最认可家庭医生提供的健康体检服务,对就医便捷性满意度的评价最高。政府应关注满意度低和满足居民需求比例低的服务项目,通过医保政策设计与分级诊疗同向发力,制订贴合不同人群的服务包,逐步提高家庭医生胜任力,增强居民对家庭医生的信任度等措施提高居民签约意愿。
Objective:To analyze the status of evaluation of contracted family doctor services among community residents in Shandong province and the influencing factors of their signing intention,so as to provide references for further improving the service quality of the contract service projects of family doctors and improving the signing rate of residents.Methods:A questionnaire survey was conducted among 618 community residents in 6 districts of Shandong province.Descriptive statistical analysis,univariate analysis and binary logistic regression analysis were conducted on the data.Results:In terms of service items,community residents believed that the top three items that met the needs of contracted services of family doctors were health examination(89.3%),diagnosis and treatment of common diseases(86.8%)and chronic disease screening(85.0%).In terms of the satisfaction evaluation,residents were most satisfied with the convenience of medical treatment and least satisfied with the medical equipment.Regression analysis results showed that the choice of medical institutions for chronic diseases,whether to know the hierarchical medical care,whether to support the contracted family doctor services,the willingness of first-visit at grassroots medical institutions and the trust in family doctors were the factors that affected the signing intention of family doctors(P<0.05).Conclusion:The community residents in Shandong province recognize the health examination services provided by family doctors the most and evaluate the satisfaction of the convenience of medical treatment the highest.Government should pay attention to the service projects of the low satisfaction and low proportion of meeting the demand of residents.It is recommended to promote the health policy design and hierarchical medical care together,make joint service pack in different populations,gradually increase the family doctor competence and improve the trust of residents in the family doctors,thus enhancing the signing intention of residents.
作者
刘晓红
马东平
宋传忠
李中玮
张翠萍
LIU Xiaohong(Weifang Medical University,Weifang,Shandong,261053,China)
出处
《医学与社会》
北大核心
2022年第3期52-57,共6页
Medicine and Society
基金
国家自然科学基金资助项目,编号为72004164
山东省社会科学规划项目“山东省社区卫生机构家庭医生签约服务的优化与推广研究”,编号为19CGLJ29
山东省社会科学普及应用研究项目“颐养天年——漫谈健康养老”,编号为2020-SKZZ-86
山东省社会科学普及应用研究项目“如何让城乡居民病有所医——山东省城乡居民医疗保险政策解读”,编号为2018-SKZZ-09。
关键词
家庭医生签约服务
社区居民
签约意愿
影响因素
Contracted Family Doctor Service
Community Resident
Signing Intention
Influencing Factor
