北京市西城区居民社区首诊意愿及影响因素研究

摘要

目的：了解北京市西城区居民的社区首诊意愿，并探讨其影响因素。方法于2014年7—8月，采用多阶段分层整群抽样的方法，在北京市西城区抽取居民1520例，以其中问卷填写有效的1499例为研究对象。采用国家卫生和计划生育委员会发展研究中心统一设计的“需方居民家庭健康询问调查表”对纳入居民进行面对面调查，具体内容包括居民基本情况、居民首诊意愿及不接受社区首诊原因、居民接受社区医疗服务情况。结果患一般性疾病时，1250例（83.4％）居民有社区首诊意愿。不同文化程度、医保类型、距离最近医疗服务机构，以及是否签约家庭医生、是否建立过健康档案、是否接受过基层医务人员主动服务居民的社区首诊意愿比较，差异有统计学意义（P﹤0.05）；不同性别、年龄、就业状况、家庭人均月收入，以及是否患有慢性病居民的社区首诊意愿比较，差异无统计学意义（P﹥0.05）。二分类Logistic回归分析结果显示，距离最近医疗服务机构、是否签约家庭医生、是否接受过基层医务人员主动服务对居民首诊意愿的影响有统计学意义（ P﹤0.05）。结论北京市西城区居民的社区首诊意愿较高，距离最近医疗服务机构、是否签约家庭医生、是否接受过基层医务人员主动服务是其影响因素。%Objective To investigate the residents'willingness to seek first contact in community health organizations and to explore the influencing factors in Xicheng District of Beijing. Methods From July to August 2014,we selected 1 520 residents from Xicheng District of Beijing by the multi-stage stratified cluster sampling method. The 1 499 research objects were filled in questionnaires effectively. We used " demand-side resident family health interview survey table" as the questionnaire which unified designed by China National Health Development Research Center. The questionnaire was employed to carry out face to face investigation,and the questionnaire content included the basic information of residents,residents'willingness to seek first contact in community health organizations,the reason of do not accept the first treatment in the community,the situation of community residents to accept community medical services. Results 1 250(83. 4%)residents have the willingness to seek first in community health organization when they suffered from common diseases. Patients with different education level, health insurance type,the nearest medical setting, signing the family doctor or not, having established health record or not and accepting the initiative service of grassroots medical staff or not were significantly different in the residents'willingness to seek first contact in community health organizations(P ﹤0. 05). Patients with different gender,age,employment status,family per capita month income and suffering from chronic diseases or not were not significantly different in the residents'willingness to seek first contact in community health organizations(P﹥0. 05). Binary Logistic regression analysis showed that the nearest medical setting,signing the family doctor or not and accepting the initiative service or not had statistical significance on residents'willingness to seek first contact in community health organizations(P﹤0. 05). Conclusion The residents in Xicheng District of Beijing have high willingness to seek first contact in community health organizations. The nearest medical setting,signing the family doctor or not and accepting the initiative service or not are influencing factors.