西藏地区中老年人家庭医生服务签约及其影响因素分析  

Analysis on influencing factors of family doctor service signing among the middle-aged and elder in Tibet

作　　者：格桑卓玛 万洋 扎西达娃[2] 熊海 GESANG Zhuo-ma;WAN Yang;ZHAXI Da-wa;XIONG Hai(Geriatrics/Neurological Department,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院神经内科,四川成都610041 [2]西藏大学医学院,西藏拉萨850000

出　　处：《现代预防医学》2023年第9期1624-1629,共6页Modern Preventive Medicine

基　　金：中央支持地方高校改革发展专项资金资助(00060585,ZFYJY201902016,ZFYJY201901005)。

摘　　要：目的 了解西藏地区中老年人家庭医生服务签约及其影响因素,为深化本地区家庭医生签约的相关卫生政策提供科学依据。方法 采用分层整群抽样方法,利用西藏地区第六次国家卫生服务调查的资料,对符合年龄≥45岁居民家庭医生签约的数据进行分析。Logistic回归方法探讨家庭医生签约情况的影响因素。结果 4 705例居民中,已签约家庭医生服务39.2%,未签约但知道家庭医生服务的居民占22.4%,不知道家庭医生服务的居民占38.4%。二元logistic分析结果显示,藏族居民(OR=2.170,95%CI:1.448~3.252)、收入水平中等(OR=0.796,95%CI:0.687~0.921)和高等(OR=0.581,95%CI:0.494~0.684)、健康分值(OR=1.455,95%CI:1.132~1.871)、患慢性病居民(OR=1.778,95%CI1.680~1.890)签约家庭医生的比例高。城镇户口居民(OR=0.468,95%CI:0.382~0.573)、上过小学(OR=1.294,95%CI:1.130~1.483)、新农合医保居民(OR=2.224,95%CI:1.169~2.296)和患慢性病者(OR=1.845,95%CI:1.738~0.968)知晓家庭医生服务的比例高。结论 西藏地区中老年人对家庭医生签约服务的知晓程度低,签约率相比西南其他地区欠佳,相关部门应加大正面宣传力度,聚焦重点人群,以提高居民知晓度及家庭医生签约服务覆盖率,为完善我国西藏地区中老年人家庭医生签约服务工作提出建议。Objective To investigate the situation and influencing factors of family doctors’service signing among the middle-aged and elder people in Tibet,to provide scientific basis for deepening the health policy of family doctors’service contract in this region.Methods Stratified cluster sampling method was used to select residents aged≥45 years,and the related data were used to analyze family doctors signing contracts based on the sixth health service survey in Tibet.Logistic regression method was used to explore the influencing factors of contract signing.Results Among the 4705 residents,39.2%signed the family doctor service,22.4%did not sign but knew about the family doctor service,and 38.4%did not know the family doctor service.The results of binary logistic analysis showed that Tibetan residents(OR=2.170,95%CI:1.448-3.252),middle level income(OR=0.796,95%CI:0.687-0.921),high level income(OR=0.581,95%CI:0.494-0.684),health score(OR=1.455,95%CI:1.132-1.871),and residents with chronic diseases(OR=1.778,95%CI:1.680-1.890)were associated with a higher proportion of family doctors contracting.Urban residents with registered permanent residence(OR=0.468,95%CI:0.382-0.573),primary school education(OR=1.294,95%CI:1.130-1.483),residents with new rural cooperative medical insurance(OR=2.224,95%CI:1.169-2.296),and people with chronic diseases(OR=1.845,95%CI:1.738-0.968)were associated with a higher proportion of knowing about family doctor service.Conclusion The middle-aged and elderly in Tibet have low awareness of the family doctor contract service,and the signing rate is poor compared with other areas in southwest China.The relevant departments should strengthen positive publicity and focus on key groups,in order to improve the awareness of residents and the coverage rate of family doctor contract service,and put forward suggestions for improving the contract service of family doctors for the middle-aged and elderly in Tibet.

关 键 词：西藏地区 中老年人群 家庭医生服务 签约 

分 类 号：R197.1[医药卫生—卫生事业管理]