浙江省基本公共卫生服务项目慢性病患者健康管理服务实施效果调查分析  

Investigation and analysis of the implementation effect of health management services for chronic diseases in basic public health service projects in Zhejiang Province

作　　者：尚晓鹏[1] 邱银伟[1] 徐校平[1] 杨清[1] 赵艳荣[1] 汪炜[1] 林君芬[1] Shang Xiaopeng;Qiu Yinwei;Xu Xiaoping;Yang Qing;Zhao Yanrong;Wang Wei;Lin Junfen(Department of Public Health Surveillance and Advisory,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China)

机构地区：[1]浙江省疾病预防控制中心公共卫生监测与业务指导所,杭州310051

出　　处：《中华健康管理学杂志》2019年第6期527-532,共6页Chinese Journal of Health Management

基　　金：浙江省医药卫生科技计划(2015ZDA008、2017KY283、2017KY296)。

摘　　要：目的调查分析浙江省基本公共卫生服务项目中慢性病患者健康管理服务知晓、利用、满意度及其影响因素。方法2017年9至11月,采用多阶段分层随机抽样的方法,在浙江省8个县(市、区)中基于信息管理系统中慢性病患者信息,利用随机数字表随机抽取当地35岁及以上慢性病患者960例。其中男性394例(41.04%),女性566例(58.96%),年龄为(68.02±10.02)岁。采用面对面问卷调查的形式,收集患者对慢性病健康管理服务的知晓、利用以及满意度情况。慢性病患者对健康管理服务的知晓、利用情况采用率进行描述分析,并对影响患者知晓、利用的可能因素采用χ^2检验和Logistic回归分别进行单因素和多因素分析。慢性病患者对健康管理服务的满意评分情况采用均数±标准差进行描述,采用t检验比较城乡间慢性病患者对服务各维度(服务便捷、服务环境、等候时间、医技水平和服务态度)的满意情况差异,并针对总体满意情况开展多因素Logistic回归分析。结果浙江省慢性病患者对健康管理服务总体知晓率为96.15%,发达地区(与较发达地区比较)、农村(与城市比较)以及非独居(与独居比较)慢性病患者对健康管理服务的知晓率更高(OR=0.347、3.563、0.281,P均<0.05);慢性病患者健康管理服务总体利用率为94.58%,发达地区(与较发达地区比较)、农村(与城市比较)慢性病患者对健康管理服务的利用率更高(OR=0.297、4.145,P均<0.05);慢性病患者对健康管理服务各维度的满意度评分均在9分以上,农村慢性病患者对服务的便捷性、服务环境、候诊时间以及服务态度的满意度均优于城市患者(t=-2.157、-3.614、-3.164、-2.879,P均<0.05);慢性病患者对健康管理服务的总体满意率为92.95%,购买城乡居民医保的慢性病患者对健康管理服务总体满意度高于购买其他医保的患者(OR=2.943,P<0.05)。结论浙江省慢性病患者对健康管�Objective To investigate and analyze the awareness,utilization,and satisfaction of patients with chronic diseases(hypertension and type 2 diabetes mellitus),as well as the influencing factors related to health management services for chronic diseases in basic public health service projects in Zhejiang Province,in order to promote the development of effective health management services for chronic diseases.Methods Between September and November 2017,960 local patients with chronic diseases aged 35 years or older were randomly selected in eight counties(cities/districts)in Zhejiang province using the random number table,based on the chronic disease information from the information management system.A total of 394(41.04%)male and 566(58.96%)female patients,with an average age of(68.02±10.02)years,participated in this study.Face-to-face questionnaires were used to collect patients’awareness,utilization,and satisfaction with health management services for chronic diseases.The awareness of health management services for chronic diseases and their utilization status were described and analyzed by statistical rate indicators.Possible factors affecting the awareness and utilization status were analyzed byχ^2 test and logistic regression.Satisfaction scores of patients with chronic diseases were analyzed by means and standard deviation.T-test was used to compare the satisfaction level with service items(service convenience,service environment,waiting time,medical skill level,and service attitude)between urban and rural patients with chronic diseases.Finally,multivariate logistic regression analysis was conducted to determine overall satisfaction.Results The overall awareness of health management services for chronic diseases in chronic disease patients was 96.15%.Multivariate Logistic regression analysis showed that patients who lived in developed regions,rural areas,and patients who did not live alone had more awareness of health management services(OR=0.347,3.563,and 0.281,all P<0.05).The overall utilization rate of

关 键 词：慢性病 健康管理 知晓率 均等化 

分 类 号：R197[医药卫生—卫生事业管理]