某市基层医疗机构综合性医疗卫生服务现状研究  

Study on the current situation of comprehensive medical and health medical services at primary medical institutions of a city

作　　者：柳松艺 孟文奇 彭海波 姜晓利 于倩倩[1] 尹文强[1] 孙葵[1] 陈钟鸣[1] 郭洪伟[1] Liu Songyi;Meng Wenqi;Peng Haibo;Jiang Xiaoli;Yu Qianqian;Yin Wenqiang;Sun Kui;Chen Zhongming;Guo Hongwei(School of Management,Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院管理学院,潍坊261053

出　　处：《中华医院管理杂志》2022年第11期857-862,共6页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(71804130)。

摘　　要：目的分析家庭医生签约服务政策下某市基层医疗机构综合性医疗卫生服务现状, 探讨影响因素并提出改进策略, 为提高基层医疗机构的医疗卫生服务水平提供参考。方法 2021年1月, 采用分层抽样方法, 选取山东省某市3个县(市、区)的18家基层医疗机构, 每家机构抽取60~70名家庭医生签约居民进行问卷调查, 问卷内容包含服务提供(19个条目)和健康问题提及频率(12个条目)2个维度。按照信息饱和原则对20名家庭医生和15名签约居民进行定性访谈, 了解当前服务需求和存在问题。所有数据采用描述性分析, 基层医疗机构综合性服务评分影响因素采用单因素方差分析和多元线性回归分析。结果本研究纳入签约居民1 098人, 基层医疗机构综合性服务评分为(3.15±0.42)分, 其中疫苗接种、孕产妇保健和健康教育项目得分较高, 分别为(3.80±0.54)分、(3.70±0.64)分和(3.78±0.57)分;皮肤科、心理健康咨询和家庭病床项目得分较低, 分别为(2.27±1.20)分、(2.97±1.01)分和(1.92±1.18)分。签约机构、性别、年龄和婚姻状况是综合性服务评分的影响因素(P<0.05)。居民对家庭病床、心理咨询和防跌倒服务的需求尚未得到满足。结论该市基层医疗机构提供了较好的综合性基本公共卫生服务, 但家庭病床、心理咨询和防跌倒服务供不应求。未来应以居民需求为导向, 采取有效措施增加服务供给, 为居民提供更加综合和全面的医疗卫生服务。Objective To evaluate the current situation of comprehensive medical and health services of primary medical institutions in a city under the policy of family doctor contracted service,and explore the influencing factors and put forward improvement strategies,for the reference to improve the medical and health service level of primary medical institutions.Methods In January 2021,18 primary medical institutions in 3 counties(cities,districts)of a city in Shandong province were selected by stratified sampling method,and 60-70 contracted residents were selected from each institution for questionnaire survey.The questionnaire covered two dimensions:service provision(19 items)and metion frequency of health problems(12 items).According to the principle of information saturation,qualitative interviews were conducted with 20 family doctors and 15 contracted residents to identify the current service needs and existing problems.Descriptive analysis was used for all data,and single factor analysis of variance and multiple linear regression analysis were used for influencing factors of comprehensive service scores of primary medical institutions.Results 1098 contracted residents were included in this study,and the comprehensive service score was 3.15±0.42.The vaccination,maternal health care and health education scored higher with 3.80±0.54,3.70±0.64,3.78±0.57 respectively;The dermatology,mental health counseling and family sickbed scored lower,with 2.27±1.20,2.97±1.01 and 1.92±1.18 respectively.Contracted institution,gender,age and marital status were the influencing factors of comprehensive service scores(P<0.05).Residents′needs for family sickbeds,psychological counseling and fall prevention had not been met.Conclusions The primary medical institutions of the city had provided better basic public health services,while unmet needs were demand for home sickbeds,psychological counseling and fall prevention.We should take effective measures to increase the service supply based on the needs of residents,and provide mor

关 键 词：基层医疗机构 综合性服务 家庭医生签约服务 居民 基本医疗质量评估量表 

分 类 号：R197.6[医药卫生—卫生事业管理]