Objective To investigate the intention and associated factors of signing a contract with a family doctor team among residents in Henan Province,China.Methods By convenience sampling,1 500 adults with literacy and effective communication skills were selected from the urban and rural areas in 14 cities (household location of the investigators of this study) in Henan Province.From December 2016 to February 2017,a survey was conducted in these participants with a self-developed questionnaire consisting of demographic data,intention of signing a contract with a family doctor team,misgivings for signing a contract with a family doctor team,and expected propagandistic ways for benefits of family doctor services.The survey obtained aresponse rate of 87.8％ (1 317/1 500).Results Of the 1 317 final participants,11.4％ (150/1 317) were willing to sign a contract with a family doctor team without misgivings,63.1％ (831/1 317) were willing to sign a contract with a family doctor team but with misgivings,12.1％ (159/1 317) had too many misgivings to sign a contract with a family doctor team and 13.4％ (177/1 317) were not willing to sign a contract with a family doctor team and thought it was unnecessary.In general,74.5％ (981/1 317) of them wanted to sign a contract with a family doctor team.The status of intention of signing a contract with a family doctor team significantly varied by age,educational attainment,occupation,type of medical insurance,type of household registration and prevalence of chronic conditions in relatives (P ＜ 0.05).Multivariate Logistic regression analysis identified that educational attainment,occupation,type of medical insurance were significantly associated with the intention of signing a contract with a family doctor team (P ＜ 0.05).The main factor why residents are worried about family doctor services is " medical level" (80.5％,1 060/1 317) and the most expected publicity method is " radio and television" (77.5％,1 020/1 317).Conclusion Most residents in Henan Province want to sign a contract with a family doctor team,but many of them have misgivings about doing so.The associated factors for signing a contract with a family doctor team are educational attainment,occupation and type of medical insurance.In view of this,it is suggested that family doctor services should be extended gradually,the priority groups and contents of services should be determined,the professional capacities of family doctors should be improved and the publicity of the contents and benefits of family doctor services should be promoted.%目的 了解河南省居民对家庭医生式服务的签约意愿,并进一步探讨居民签约意愿的影响因素.方法 采用方便抽样法,根据调查员家庭所在地,以河南省14个市的农村和城镇作为调查地区,选取年龄为18周岁及以上、识字、交流沟通能力良好的居民为研究对象.于2016年12月-2017年2月,采用自行设计的调查问卷进行调查.问卷主要内容有:居民的基本情况、居民的家庭医生式服务签约意愿、使居民产生顾虑的因素及希望家庭医生式服务的宣传方式.共发放问卷1 500份,回收有效问卷1 317份,问卷的有效回收率为87.8％.结果 1 317例居民中,150例(11.4％)选择“愿意签约且无顾虑”,831例(63.1％)选择“愿意签约但有顾虑”;159例(12.1％)选择“不愿意签约且顾虑太多”,177例(13.4％)选择“不愿意签约且认为没必要”,总的签约意愿为74.5％ (981/1 317).不同年龄、学历、职业、医疗保险类型、户口类型及亲属是否患慢性病的居民对家庭医生式服务的签约意愿比较,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示,学历、职业、医疗保险类型是居民对家庭医生式服务签约意愿的影响因素(P＜0.05).居民对家庭医生式服务产生顾虑的最主要因素为“医术水平” (80.5％,1 060/1 317),最希望家庭医生式服务采取的宣传方式为“广播电视”(77.5％,1 020/1 317).结论 河南省居民签约家庭医生式服务意愿较高,但大多数居民存在顾虑,学历、职业、医疗保险类型是居民对家庭医生式服务签约意愿的影响因素.建议逐步推进家庭医生式服务、明确重点服务对象与内容、提升家庭医生职业素养、加大对家庭医生式服务内涵的宣传.
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