基于居民需求视角分析兰州市家庭医生签约服务  

An Analysis on the Signing Service of Family Doctors in Lanzhou City Based on the Residents’Needs

作　　者：陈佳琦 白润娟 张晓岚[2] 李芳 张德娟[2] CHEN Jiaqi;BAI Runjuan;ZHANG Xiaolan;LI Fang;ZHANG Dejuan(Nursing College,Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of Traditional Chinese Medicine)

机构地区：[1]甘肃中医药大学护理学院,甘肃兰州730000 [2]甘肃省中医院

出　　处：《西部中医药》2021年第1期78-82,共5页Western Journal of Traditional Chinese Medicine

基　　金：甘肃省卫生健康委员会社区项目。

摘　　要：目的:了解兰州市家庭医生签约服务情况及现阶段居民对服务的需求,为甘肃省其他地区更好地开展签约服务提供参考。方法:采用典型调查法于2019年8~10月选取兰州市城关区、安宁区、七里河区、西固区业务开展良好的社区卫生服务机构的217名医护人员和866名社区就诊居民为调研对象,以问卷调查的形式进行实地调查。结果:回收居民有效问卷812份,其中已签约502人(61.8%),愿意签约主要原因是体检更方便68.9%(346/502)、看病更方便为65.3%(328/502);未签约310人(38.2%),不愿签约主要原因依次是家庭医生技术不高、服务效果不好为32.9%(102/310)、社区就诊条件不好为30.3%(94/310)。职业、是否参加医保、慢病患病情况是居民签约的影响因素,差异有统计学意义(P<0.05)。居民对服务需求排列前2的是出诊和送药服务为55.2%(448/812)、进行心理问题咨询服务为47.3%(384/812);对健康管理需求排列前二的是开展糖尿病、高血压等慢性病管理为76.7%(623/812)、建立家庭健康档案占75.6%(614/812)。结论:兰州市家庭医生签约率较低,缺乏居民信任和了解,居民对家庭医生服务项目需求大,但实际提供服务项目不能满足居民需求,服务质量不高。因此加大政策宣传力度、优化服务项目、提高服务质量至关重要。Objective:To provide the reference for launching signing service in others districts of Gansu province better by understanding the signing conditions of family doctors in Lanzhou city and the residents’needs for the service at this stage.Methods:Using typical investigation method,217 medical staffs and 866 community residents from the community health service institutions with good business development in Chengguan district,Anning district,Qilihe district and Xigu district of Lanzhou city were chosen from August to October,2019 to perform field investigation using questionaire.Results:Among 812 valid questionnaires for residents,502 residents had signed up(61.8%),the main reasons for willing to sign a contract were that physical examinations were more convenient 68.9%(346/502),seeing the doctor convenient 65.3(328/502);310 residents didn’t sign the contract(38.2%),the main reasons for not signing the contract were family doctors are not skilled,the service effects are not good 32.9%(102/310),and the conditions of community treatment are not good 30.3%(94/310).Occupation,whether to participate in medical insurance and the conditions of chronic disease were the influencing factors of the residents signing the contract,and the difference showed statistical meaning(P<0.05).The residents’demands for service ranked the top two were visiting the patients at home and drug delivery service 55.2%(448/812),performing psychological counseling service 47.3%(384/812);the demand for health management ranked the top two were carrying out the management of diabetes,hypertension and others 76.7%(623/812)),and establishing family health records 75.6%(614/812).Conclusion:The signing rate of family doctors in Lanzhou is relatively low,lacking the trust and understanding of residents.The residents have a large demand for family doctor services,but the actual service projects cannot meet the needs of residents and the service quality is not high.Therefore,it is important to increase policy publicity,optimize service items and imp

关 键 词：居民需求 家庭医生签约服务 签约率 调查分析 

分 类 号：R197[医药卫生—卫生事业管理]