家庭医生签约与非签约居民卫生服务利用差异  

Disparity in health service utilization between residents with and without contracted family doctor services in Jiangsu province

作　　者：吴瑶琴 徐爱军 陈安琪 李红美 夏有兵 WU Yao-qin;XU Ai-jun;CHEN An-qi(School of Public Health,Nanjing Medical University,Nanjing,Jiangsu Province 210029,China;不详)

机构地区：[1]南京医科大学公共卫生学院,江苏南京210029 [2]南京中医药大学卫生经济管理学院

出　　处：《中国公共卫生》2021年第10期1540-1542,共3页Chinese Journal of Public Health

基　　金：国家社科基金专项研究(2018VJX065);江苏省中医药科技项目(ZD201801)。

摘　　要：目的比较已签约和未签约居民卫生服务利用差异,为进一步优化家庭医生服务制度提供参考。方法利用2018年江苏省第六次卫生服务调查中家庭健康调查表中数据,采用2周患病率、高血压和糖尿病患病率、其他慢性病患病率反映卫生服务需求情况,采用2周就诊率、住院率、自我治疗率、自行购药率、医疗费用及就诊和住院机构反映卫生服务利用情况。结果签约居民2周患病率、慢性病患病率及高血压、糖尿病患病率均高于非签约居民,差异具有统计学意义(P<0.05);签约居民住院率、自我治疗率、自行购药率均高于非签约居民,差异具有统计学意义(P<0.05);签约居民与非签约居民在首诊机构和住院机构的选择上差异具有统计学意义(P<0.05)。结论签约居民卫生服务需求更高,同时卫生服务利用水平也更高;签约居民更倾向于去基层就诊;签约对医疗费用的控制作用尚未体现。Objective To compare the disparity in health service utilization between the residents with and without contracted family doctor services and to provide evidences for improving family doctor service system. Methods The data of the study were from the Sixth National Health Service Survey conducted in 2008. Valid information on health service demand and utilization were collected via questionnaire interviews from a total 4 398 urban and rural residents living in 6 prefectures/counties/districts acorss Jiangsu province in 2008. Results The proportion of the residents with and without contracted family doctor services were 42.81%(n = 1 883) and 57.19%(n = 2 515), respectively. Compared to those without contracted family doctor services, the residents with the services reported significantly higher rate of two-week prevalence,the prevalence rates of chronic disease, hypertension and diabetes, and the rates of hospitalization, self medication and buying medicine by themselves(P < 0.05 for all). Conclusion In Jiangsu province, the urban and rural residents with contracted family doctor service have both higher health care demands and medical services utilization and the residents are more likely to visit doctors in grassroots medical institutions in comparison with the residents without contracted family doctor services.The effect of contracted family doctor services on reducing medical expenses is not yet observed.

关 键 词：家庭医生 签约 非签约 卫生服务利用 

分 类 号：R195[医药卫生—卫生统计学]