上海市某区居民社区首诊意愿及其影响因素  

Residents'Willingness for First-visit Care in the Community and Influencing Factors in a District of Shanghai

作　　者：王一清 唐雪 应晓华[1] WANG Yiqing(School of Public Health,Fudan University,Shanghai,200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032

出　　处：《医学与社会》2025年第4期37-43,共7页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为72074051。

摘　　要：目的:分析上海市某区居民社区首诊意愿及其影响因素,为社区医疗资源配置提供参考依据。方法:于2023年7月对上海市某区10个街道的居民开展线上问卷调查,共收集到16539份有效样本。采用描述性分析和分层分析方法分析居民社区首诊意愿及其差异,使用logistic回归分析居民社区首诊意愿的影响因素。结果:在16539名调查对象中,有12071人(73.0%)愿意到社区首诊。分层分析结果显示,不同社会经济地位和人口学特征的居民社区首诊意愿不同,相对而言,年龄较大者和慢性病患者等群体更愿意到社区首诊;而较高文化程度、较高收入水平者等群体更不愿意到社区首诊(P<0.05)。结论:上海市某区居民社区首诊意愿较高,年龄、文化程度、平均月收入、是否患慢性病、到最近社区卫生服务机构的距离、社区卫生服务满意度是居民社区首诊意愿的重要影响因素。建议结合社区居民需求及其特点提供相应服务,及时找出影响居民社区首诊的原因,以进一步巩固和提高居民社区首诊意愿。Objective:To analyze the willingness of residents in a certain district of Shanghai to seek first-visit care in the community and the influencing factors,so as to provide references for the allocation of community medical resources.Methods:In July 2023,an online questionnaire survey was conducted among residents in ten streets in a certain district of Shanghai,collecting 16539 valid responses.Descriptive and stratified analyses were used to assess the current state of residents'willingness for first-visit care and its differences,while logistic regression analysis identified the influencing factors.Results:Among the 16539 respondents,12071 individuals(73.0%)were willing to seek first-visit care in the community.Stratified analysis showed differing willingness across groups with various socioeconomic statuses and demographic characteristics.Relatively,older individuals and chronic disease patients were more willing to seek first-visit care,and groups with higher education and income levels were less inclined to seek first-visit care in the community(P<0.05).Conclusion:Residents in a certain district of Shanghai showed a high willingness for first-visit care in the community.Important influencing factors included age,education level,average monthly income,presence of chronic disease,distance to the nearest community health service facility,and satisfaction with community health services.It is recommended to provide tailored services based on community residents'demands and characteristics to improve the factors affecting their willingness for first-visit care,thereby further consolidating and enhancing this willingness.

关 键 词：社区首诊 意愿 居民 影响因素 上海 

分 类 号：R-05[医药卫生] R197.1