目的 探讨徐州市城区居民签约家庭医生意愿及影响因素,为家庭医生签约制度的实施与推广提供可行建议.方法 采用分层随机抽样方法,应用自行设计的调查问卷进行入户调查,应用统计描述、单因素分析、多因素logistic回归对调查数据进行分析.结果 1397名调查对象中,57.84%愿意签约家庭医生.多因素logistic回归分析显示,影响居民签约家庭医生服务的因素有年龄、个人年收入、文化程度、从家至社区卫生服务中心的步行时间、自评健康状况、健康体检经历、基层就诊经历、对家庭医生签约制度的知晓情况.结论 徐州市城区居民家庭医生签约服务的签约意愿较强,但调查签约率并不高.各级医疗卫生机构应加强制度的真实有效宣传;发展潜在签约对象,逐步拓宽签约人群;适度调整签约费用,循序渐进实现政策的全面推广;进一步细化医疗需求层次,打造符合现代医学模式的家庭医生签约服务.%Objective To investigate the urban residents' willingness of family doctor service contracts and its influencing factors in Xuzhou,and to provide feasible suggestions for the implementation and promotion of family doctor services. Methods A stratified random sampling was conducted,and the subjects were surveyed with self-designed questionnaire. Data were analyzed with statistical description,single factor analysis,and multivariate logistic regression analysis. Results Among the 1 397 subjects,57.84% were willing to contract with family doctors. Results of multivariate logistic regression showed that the influencing factors of residents' willingness of contracting family doctor were age,personal income,education level,the walking-time from home to the community healthcare center,self-rated health condition, health examination experience,primary health services for medical treatment,and the awareness of family doctor services. Conclusion The residents' willingness of contract with family doctors is considerable in the urban area of Xuzhou,but the investigated contract rate is not high. It is suggested that medical and healthcare institutions strengthen the effective propaganda of the family doctor system. It is also proposed to develop potential contract targets and expand the contracted population gradually,and adjust the signing expenditure appropriately and achieve a comprehensive promotion of policy. Meanwhile,further refining of the demand hierarchy of medical care and constructing a family doctor service system in accordance with modern medical mode are also proposed.
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