武汉市居民家庭医生签约情况及影响因素分析  

Status of signing a contract with family doctors and its influencing factors among residents in Wuhan City

作　　者：柯思思[1] 郭燕[1] 严亚琼[1] KE Si-si;GUO Yan;YAN Ya-qiong(Wuhan Centres for Disease Prevention and Control,Wuhan 430071,China)

机构地区：[1]武汉市疾病预防控制中心慢性非传染性疾病防治所,湖北武汉430071

出　　处：《中国健康教育》2022年第11期1022-1027,共6页Chinese Journal of Health Education

基　　金：武汉市卫生计生委项目(WG19Y07);湖北省卫生计生委科研项目(WJ2019F011)

摘　　要：目的了解武汉市家庭医生签约服务知晓和签约情况,探讨影响居民签约的主要因素,为提高居民签约率提供参考依据。方法采用多阶段整群随机抽样的方法,于2019年7月至2020年1月,对武汉市14个区10473位居民进行问卷调查。采用Logistic回归方法分析家庭医生签约服务的影响因素。结果共回收有效问卷10253份,有效回收率为97.90%。其中25.52%的居民已签约、54.78%的居民听说过家庭医生签约服务。中心城区、有医疗保险、不吸烟、知晓慢性病核心知识和知晓家庭医生签约服务的居民知晓率和签约率更高(P<0.05)。不同年龄、受教育程度、婚姻状况、就业状况、慢性疾病患病情况、健康状况自评的居民签约率有差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄为25~44岁(OR=1.415,95%CI:1.093~1.831)、65岁及以上(OR=1.749,95%CI:1.275~2.400)、中心城区(OR=1.353,95%CI:1.213~1.510)、文化程度为初中(OR=1.301,95%CI:1.092~1.550)、高中/中专(OR=1.813,95%CI:1.510~2.177)、大专及以上(OR=3.244,95%CI:2.681~3.926)、婚姻状况为离异/丧偶(OR=1.375,95%CI:1.021~1.868)、已婚(OR=1.369,95%CI:1.120~1.674)、有医疗保险(OR=1.616,95%CI:1.311~1.992)、离退休(OR=1.666,95%CI:1.370~2.026)、在业(OR=1.330,95%CI:1.127~1.568)、患有一种慢性病患病(OR=1.387,95%CI:1.220~1.577)、患有二种及以上慢性病患病(OR=1.532,95%CI:1.282~1.830)、不吸烟(OR=1.167,95%CI:1.040~1.311)、知晓慢性病核心知识(OR=1.683,95%CI:1.524~1.858)、的居民更倾向于签约。结论武汉市家庭医生签约服务签约率和知晓率均不高,建议从拓宽宣传和队伍来源渠道、完善补偿机制、优化服务方式、丰富签约服务内涵、提高居民健康素养等方面推进家庭医生签约服务。Objective To understand the current status of family doctor service contract and to explore its influencing factors in Wuhan,and to provide the references to improve the signing rate.Methods By using multistage cluster sampling method,10473 community-dwelling residents from 15 districts were recruited from Wuhan Citybetween July 2019 and January 2020.Logistic regression model was adopted to discuss the factors of family doctor service contract.Results Total 10253valid questionnairewere obtained,the response rate was 97.9%.25.52%of residents had signed up for family doctor service,54.78%heard of family doctor service contract.The residents in urban area,medical insurance,non-smoking,knowledge of core chronic diseases,awareness of family doctor contracted services,had higher awareness rates and contracting rates(P<0.05).Age,educational level,marital status,employment status,chronic disease prevalence and health status were different between the contracted and non-contracted residents(P<0.05).The logistic regression showed that aged 25-44(OR=1.415,95%CI:1.093-1.831),aged 65 and above(OR=1.749,95%CI:1.275-2.400),urban areas(OR=1.353,95%CI:1.213-1.510),junior high school(OR=1.301,95%CI:1.092-1.550),high school/secondary school education level(OR=1.813,95%CI:1.510-2.177),college degree and above(OR=3.244,95%CI:2.681-3.926),divorced/widow/widower(OR=1.375,95%CI:1.021-1.868),married(OR=1.369,95%CI:1.120-1.674),having medical insurance(OR=1.616,95%CI:1.311-1.992),the retired(OR=1.666,95%CI:1.370-2.026),employment(OR=1.330,95%CI:1.127-1.568),having one chronic disease(OR=1.387,95%CI:1.220-1.577),having two or more chronic diseases(OR=1.532,95%CI:1.282-1.830),non-smoker(OR=1.167,95%CI:1.040-1.311),knowing the core knowledge of chronic disease(OR=1.683,95%CI:1.524-1.858)were more likely to sign family doctor contract service.Conclusion The awareness and signing rate of family doctor contract service are not high in Wuhan.In order to promote family doctor contract service,it is necessary to strengthen the propagation of the p

关 键 词：家庭医生服务 LOGISTIC回归 知晓率 签约率 

分 类 号：R197.1[医药卫生—卫生事业管理]