首都医科大学附属复兴医院月坛社区卫生服务中心家庭医生签约慢性病患者预约门诊现况分析

摘要

Objective To investigate the appointment situation and its influencing factors of family doctor service among contracted patients with chronic diseases (hypertension,diabetes,coronary heart disease,and cerebrovascular disease) in Yuetan Community Health Service Center,Affiliated Fu Xing Hospital of Capital Medical University. Methods Based on inclusion and exclusion criteria,200 patients with chronic diseases who had registered in Yuetan Community Health Service Center and its nine affiliated clinics were selected through systematic sampling from June 1st,2015 to May 31st,2016. As per appointment situation,these 200 patients were divided into attendance group (n = 100)and non-attendance group (n = 100). All patients were required to complete the self-designed Family Doctor Service Appointment in Yuetan Community Questionnaire. Results Multiple Logistic regression analyses showed that marital status (divorced or widowed) 〔OR = 1. 997, 95％ CI (1. 124,3. 549)〕and satisfaction degree of the appointment process 〔OR = 0. 242,95％ CI (0. 133,0. 439)〕were factors associated with the attendance of patients (P < 0. 05). The main reasons for non-attendance were conflicting with other personal issues (65. 0％,65 / 100)and forgetting the appointment (51. 0％,51 / 100). Conclusion The compliance rate of the appointment of family doctor service among contracted patients with chronic diseases in Yuetan Community Health Service Center,Affiliated Fu Xing Hospital of Capital Medical University is low,so in order to improve the compliance rate,family doctors should pay more attention to patients who are divorced or widowed,and improve the appointment process of outpatient treatment.%目的 了解首都医科大学附属复兴医院月坛社区卫生服务中心家庭医生签约慢性病(高血压、糖尿病、冠心病、脑血管病)患者预约门诊情况及其影响因素.方法 采用系统抽样法,根据纳入与排除标准,选取2015-06-01至2016-05-31首都医科大学附属复兴医院月坛社区卫生服务中心及其下属的9个社区卫生服务站的家庭医生签约慢性病患者200例为调查对象.根据履约情况,将其分为履约组(100例)和爽约组(100例).采用自行设计的月坛社区"家庭医生式服务"预约就诊调查问卷进行调查.结果 多因素Logistic回归分析结果显示,婚姻状况(离异或丧偶)〔OR=1.997,95％CI(1.124,3.549)〕、预约过程满意度 〔OR=0.242,95％CI(0.133,0.439)〕是慢性病患者履约行为的影响因素(P<0.05).爽约组患者爽约原因主要为临时有事无法就诊65例(65.0％)、遗忘51例(51.0％).结论 首都医科大学附属复兴医院月坛社区卫生服务中心家庭医生签约慢性病患者预约门诊履约率偏低,家庭医生应更多关注离异或丧偶患者,提高预约门诊服务满意度,完善预约门诊就诊流程,只有这样才能提高履约率.