脑卒中患者住院期间对家庭医生制服务需求的调查  

A survey on demand of stroke victims for family physician service

作　　者：陈先辉[1] 孙国平[1] 王家骥[2] 景孟娟 孙静钗 黄鸿[1] 周小彦[2] 罗建业[1] 伍旭炽 朱伟梁[1] 何强[1] 

机构地区：[1]广东省深圳市坪山新区人民医院社管中心,518118 [2]广州医科大学公共卫生学院,510182 [3]河南大学护理学院 [4]武汉大学公共卫生学院

出　　处：《中华全科医学》2015年第7期1151-1153,共3页Chinese Journal of General Practice

基　　金：广东省医学科学技术研究基金(A2014671)

摘　　要：目的了解脑卒中患者对家庭医生服务的需求及对家庭医生服务的知晓及满意度,为改善家庭医生制服务提供参考。方法采用自行设计的问卷,对深圳某医院2013年8月—2014年8月脑卒中患者或家属开展调查。结果调查共发放491份问卷,有效问卷483份。按是否签订家庭医生服务分为签约组和未签约组,2组在性别、婚姻状况、文化程度、职业、疾病情况及居住方式等维度差异无统计学意义(P>0.05),在年龄(t=2.54)、家庭收入(χ2=8.39)、医疗保险类型(χ2=84.62)维度差异有统计学意义(P<0.05),签约组年龄(58.94±7.66)岁小于未签约组(63.86±7.16)岁,家庭收入和医保覆盖率优于未签约组;对未签约组进行分析显示未签约原因前三位为"不了解"41例,"社康中心医疗设备不足"17例,"医生技术水平有限"15例。对签约组进行满意度调查显示家庭医生服务态度满意率84.08%、技术满意78.98%,主动服务满意率63.06%,医患沟通满意率47.13%;签约组84.28%的患者希望家庭医生能与专科医生一起,提供综合性医疗服务。结论脑卒中患者家庭医生签约率低,与其对家庭医生制服务模式的不了解和现行家庭医生制服务的不健全有关,应加大家庭医生服务的推广,改进现有的家庭医生服务模式,从而真正做到为患者及社区居民服务。Objective To investigate the demands, awareness and the degree of satisfaction of stroke victims for family physician service, and provide reference for the improvement of family physician system. Methods A self-designed ques- tionnaire survey was conducted among the stroke victims or their family members from August 2013 to August 2014. Re- suits 483 valid survey response from 491 survey respondents were collected. The subjects were divided into signing group and non-signing group according to whether or not signing the family physician. No significance difference between the groups had been observed in gender, marital status, degree of education, occupation, mode of living, disease conditions and living arrangement （ P 〉 0.05 ）, but the difference in age （ t = 2.54）, family income （ x^2 = 8.39 ） and type of medical insurance （ x^2 = 84.62） was significant （ P 〈 0.05 ）. Signing group [ （ 58.94 ± 7.66 ） y ] was younger than non-signing group [ （63.86 ± 7.16）y ], and better in family income and type of medical insurance as compared with the non-signing group; The top three reasons for not signing a family physician in non-signing group were ： knowing few about the family physician service（41 cases） ,lack of equipment in Community Health Centre（ 17 cases） ,low level of the doctor（ 15 cases）. The de- gree of satisfaction for family physician system service in signing patients were service satisfaction 84.08% ,technology of satisfaction 78. 98%, initiative satisfaction 63. 06%, and doctor-patient communication 47. 13% ; In signing group 84.28% of the patients hoped having a medical team to supply comprehensive service for them. Conclusion The rate of stroke victims for signing family physician is very low because of the few knowing about the family physician service and the deficiencies in family physician system,we should advertise more and improve the family physician system service to supply better service to patients.

关 键 词：脑卒中 家庭医生制 卫生服务需求 PCMH 

分 类 号：R743[医药卫生—神经病学与精神病学] R195[医药卫生—临床医学]