中老年人群对社区卫生服务利用及满意度影响因素的调查  

Investigation and analysis of the influencing factors for utilization and satisfaction of community health service among middle aged and elderly populations

作　　者：熊咏珍 许晓佳 杨海云 潘聪聪 许伟华 杨艳艳 谢培豪 倪进东 

机构地区：[1]广东医科大学医院管理处,广东东莞523808 [2]广东医科大学公共卫生学院,广东东莞523808 [3]东莞市环境医学重点实验室,广东东莞523808 [4]广东医科大学养老产业研究院,广东东莞523808 [5]广东医科大学护理学院,广东东莞523808

出　　处：《现代预防医学》2016年第18期3353-3357,共5页Modern Preventive Medicine

基　　金：东莞市科技计划项目(2012108102019);广东医学院教育教学研究课题(2JY14031);教育教学成果奖(高等教育)培育项目(2JY14025)

摘　　要：目的了解东莞市中老年人对社区卫生服务利用及满意度的影响因素,为养老服务体系的建设规划提供依据。方法随机抽取东莞市55岁以上中老年人,通过问卷调查社区卫生服务首诊率和满意度,并对其影响因素进行分析。结果共调查798名中老年人,其中发生疾病时首诊选择社区卫生服务机构的有16.6%;其中就职单位属性为民营企业的中老年人社区卫生服务首诊率比就职党政机关的高（OR=3.701,P=0.023）;而享受公费医疗的比使用城镇职工保险低（OR=0.434,P=0.025）;健康状况一般化、不健康的均比健康人群低（OR=0.496,P=0.020,OR=0.321,P=0.035）;首诊单位选择原因中认为是价格低的比因医保定点单位的高（OR=3.352,P〈0.001）。影响中老年人对社区卫生服务机构满意度的因素分析中,健康状况为一般化的中老年人满意度低于健康人群（OR=0.488,P=0.016）;家庭月收入为15 000～20 000元的低于30 000元以上的（OR=0.059,P=0.018）。结论就职单位属性、医疗费用支付方式、健康自评、选择首诊单位原因是影响中老年人首诊选择社区服务机构的主要因素。健康自评、家庭月收入是影响中老年人对社区卫生服务满意度的主要因素。Objective The study was conducted to assess the influencing factors for utilization and satisfaction of community health service among middle aged adults and elderly in Dongguan City, and thus to provide a reference for the development and planning of elderly care service systems. Methods Middle aged and elderly residents over 55 years of age in Dongguan were randomly selected and surveyed by questionnaires for the first clinical visit rate of and satisfaction level for community health services. The influencing factors were also analyzed. Results A total of 798 middle aged and elderly residents were surveyed. 16.6% of the residents chose community health service institutions for their first clinical visits, in terms of which those who are or were employees of private sectors had higher utilization rate than those who work or works at the communist party and government organizations （OR =3.701, P=0.023）; those who are beneficiaries of public health service had lower utilization rate than those having urban employee insurances （OR=0.434, P=0.025）; those whose health conditions are normal or poor had lower utilization rate than healthy ones （OR=0.496, P=0.020, 0R=0.321, P=0.035）. In terms of the reasons for choice of places for their first clinical visit, low price was more commonly considered than medical insurance-designated institutions （OR=3.352, P〈0.001）. In terms of the factors affecting the satisfaction level toward community health services, those whose health conditions are normal were less satisfied than the healthy ones （OR=0.488, P=0.016）; and those having a monthly family income of ￥15000-20000 RMB were less satisfied than those having a monthly family income of over ￥30000 RMB （OR =0.059, P=0.018）. Conclusion Among the middle aged and elderly residents, ownership type of employment, payment method of medical expenses, self-assessment of health, and reasons for choice of place for first clinical visits are the major factors influencing the utilization rate of community hea

关 键 词：中老年 社区卫生服务 满意度 首诊 

分 类 号：R192[医药卫生—卫生事业管理]