老年慢性病患者对家庭医生签约服务满意度分析  

Analysis on Satisfaction of Elderly Patients with Chronic Disease with Contracted Services of Family Doctors

作　　者：李丹 肖艳杰[1] 崔笑晨 姚健 李志强 Li Dan;Xiao Yanjie;Cui Xiaochen;Yao Jian;Li Zhiqiang(School of Public Health,Jinzhou Medical University;Jinzhou Center for Disease Control and Prevention,Jinzhou 121000 China)

机构地区：[1]锦州医科大学公共卫生学院 [2]锦州市疾病预防控制中心,辽宁锦州121000

出　　处：《锦州医科大学学报》2021年第5期85-91,共7页Journal of Jinzhou Medical University

基　　金：辽宁省自然科学基金计划项目,项目编号:20180550339。

摘　　要：目的应用结构方程模型,了解锦州地区老年慢性病患者对家庭医生签约服务的满意度及其影响因素。方法2020年7月1日至2020年7月31日,采用分层随机抽样的方法,对锦州市20个社区卫生服务中心的2000名社区居民采用自行编制的调查问卷(Cronbach sα=0.970,KMO=0.943)进行调查,收集调查对象的基本情况和与家庭医生签约服务满意度相关资料,提取医疗环境、家庭医生技术水平、心理因素和签约服务利用情况四个潜变量。结果居民对医疗环境的满意情况、居民对家庭医生技术水平的满意情况、居民心理因素方面对家庭医生的满意情况能够对家庭医生签约服务的利用情况造成影响,家庭医生签约服务满意情况和家庭医生签约服务利用情况是存在一致性的(P<0.001),Spearman相关性检验结果显示,居民对医疗环境的满意情况、居民对家庭医生技术水平的满意情况、居民心理因素方面对家庭医生的满意情况和签约服务利用情况正相关(P<0.01)。构建居民满意度预测居民签约利用情况的理论模型,路径系数估计与检验结果显示医疗环境的满意情况、家庭医生技术水平的满意情况、居民心理因素方面的满意情况对居民签约服务利用情况的路径系数以及路径系数的估计,差异有统计学意义(P<0.05),医疗环境的满意情况、家庭医生技术水平的满意情况、居民心理因素方面的满意情况对居民签约服务利用情况R^(2)=0.85。结论提高老年慢性病患者对家庭医生签约服务满意度,可以通过提高医疗环境、家庭医生技术水平、改善居民心理因素3个方面进行有效干预,从而提高居民家庭医生的利用率。Objective Structural equation model was applied to understand the satisfaction of elderly patients with chronic disease with family doctor contracted services in Jinzhou and its influencing factors.Methods From July 1 to July 31,2020,a self-prepared questionnaire(Cronbach'sα=0.970,KMO=0.943)was conducted among 2000 residents from 20 community health service centers in Jinzhou with stratified random sampling.The basic information of the survey subjects and related data of the satisfaction with family doctor contracted services were collected,and four latent variables including medical environment,technical level of family doctors,psychological factors and utilization of contracted services were extracted.Results Residents'satisfaction with the medical environment as well as technical level of family doctors and psychological factors could influence the utilization of family doctor contracted services.There was consistency between the satisfaction with family doctor contracted services and the utilization(P<0.001).The Spearman correlation test showed that residents'satisfaction with the medical environment,technical level of family doctors,psychological factors and utilization of contracted services were positively correlated(P<0.01).The theoretical model of residents'satisfaction predicting residents'utilization of contracting services was constructed.The results of path coefficient estimation and testing showed,as regards the satisfaction with medical environment,technical level of family doctors and residents'psychological factors,there were statistically significant differences in the path coefficient of the utilization of residents'contracted services and the estimation of path coefficient(P<0.05).The effect of the satisfaction with the medical environment,technical level of family doctors,and psychological factors of the residents on the utilization of residents'contracting services was R^(2)=0.85.Conclusion To improve the satisfaction of elderly patients with chronic diseases with the contracted services of

关 键 词：结构方程模型 家庭医生 签约服务 满意度分析 

分 类 号：R195.4[医药卫生—卫生统计学]