“1+1+1”医疗机构组合签约下社区居民社区就诊次数及影响因素分析  

Healthcare-seeking behaviours and their influencing factors among community residents under the context of"1+1+1"type of contracted family doctor service

作　　者：季晖 JI Hui(Huaihai Zhonglu Community Health Service Centre,Huangpu District,Shanghai 200025,China)

机构地区：[1]上海市黄浦区淮海中路社区卫生服务中心,上海200025

出　　处：《中华全科医学》2021年第9期1522-1525,共4页Chinese Journal of General Practice

基　　金：上海市黄浦区卫生健康委员会面上项目(HKM201732)。

摘　　要：目的分析"1+1+1"医疗机构组合签约实施下社区居民社区就诊次数及影响因素,为进一步完善家庭医生签约工作提供依据。方法本研究于2019年6—11月采用随机数字表法对上海市黄浦区淮海中路社区卫生服务中心的2018年门诊居民进行抽样调查。调查内容包括人口社会学信息、健康情况、就诊次数。采用SPSS 24.0统计学软件进行统计分析,P<0.05为差异有统计学意义。结果1204位居民在2018年社区就诊次数中位数为3(1,11)次,人均就诊次数为10.4次。单因素分析结果显示,不同签约情况、签约时长、年龄、职业、离退休状态、文化程度、婚姻状态、每月可支配收入,是否患有高血压/高血脂/糖尿病/脑卒中/心脏疾病/消化道疾病/其他疾病,是否需要长期用药,有无配药/基本诊疗需求不同的居民,其2018年社区就诊次数差异有统计学意义(均P<0.05)。多因素分析结果显示,签约、签约时长、年龄、消化道疾病、配药是2018年社区就诊次数的独立影响因素(均P<0.05)。其中,签约、签约时间久、高龄、有配药需求是居民到社区就诊的促进因素;消化道疾病是居民到社区就诊的阻碍因素。结论"1+1+1"医疗机构组合签约有利于引导社区居民到社区卫生服务中心就诊,而社区卫生服务中心在"1+1+1"医疗机构签约吸引居民到社区就诊的同时,也需注意对自身临床技能的提升,以应对居民多样化的健康管理需求。Objective To analyse the characteristics and of healthcare-seeking times in community and their influencing factors among community residents under the context of"1+1+1"type of contracted family doctor service and so as to provide a basis for further improving the work of contracting family doctors services.Methods Random sample surveys were conducted among the outpatients in Huaihai Zhonglu Community Health Service Centre in Huangpu District,Shanghai,in 2018 from June 2019 to November in 2019.The sociological information,health status and data on the medical behaviour of these patients were collected.Data were analysed using SPSS 24.0.P values was under 0.05,results were considered statistically significant.Results The median number of community visits for 1204 residents was 3(1,11),and the number of visits per patients was 10.4.Single factor analysis revealed that people with different signing statuses,signing durations,age,occupations,retirement statuses,education levels,marital status,monthly disposable income,diseases(such as hypertension,hyperlipidaemia,diabetes,stroke,heart disease,digestive tract diseases etc.),requiring long-term medication or not and requiring prescription or basic diagnosis and treatment or not,showed statistically significant difference in terms of the number of community visits(all P<0.05).Multifactor analysis results showed that signing statuses,signing durations,age,gastrointestinal diseases and dispensing medicines were independent influencing factors for the number of community visits(all P<0.05).Signing a(long-term)contract,seniority and the need for dispensing medicines were the factors that induce residents to visit the community;by contrast,gastrointestinal diseases were the factors that hinder residents to visit the community.Conclusion The"1+1+1"type of contracted family doctor services is helpful in promoting visits to community health service centres.Given that this type of service attracts residents to communities,community health service centres should improve the clini

关 键 词：“1+1+1”医疗机构组合签约 就诊次数 影响因素 

分 类 号：R197.6[医药卫生—卫生事业管理]