中国全科医学2017，Vol.20Issue(25)：3104-3108,5.DOI:10.3969/j.issn.1007-9572.2017.25.009
分级诊疗制度下徐州市社区居民的社区卫生服务机构首诊情况及影响因素研究
Status and Associated Factors for Receiving First Contact Care Delivered by Community Health Institutions in Community Residents in Xuzhou During the Implementation of the Hierarchical Diagnosis and Treatment System
摘要
Abstract
Objective To investigate the status and associated factors for receiving first contact care delivered by community health institutions in community residents in Xuzhou,China during the implementation of hierarchical diagnosis and treatment system,in order to provide some constructive suggestions for diverting patients reasonably,optimizing their health-seeking behavior and improving the role of the hierarchical diagnosis and treatment system.Methods Seven hundred and fifty community residents were selected by stratified multistage random sampling in 3 subordinate counties (districts) of Xuzhou from July to August in 2016.They were surveyed by a structured questionnaire designed by our research team consisting of questions about demographic characteristics,awareness level of the hierarchical diagnosis and treatment system and the choice of medical treatment during the implementation of the hierarchical diagnosis and treatment system.The survey achieved a response rate of 94.7％ (710/750).Results Of the participants,86.5％ (614/710) had a history of illness in 1 year,78.2％ of them (480/614) sought medical services when they had an illness recently,and 53.1％ (255/480) first received the care provided by community health service institutions.The rate of receiving first contact care delivered by community health service institutions varied significantly by education level,occupation,average monthly income and medical expenses of the preceding year,selfperceived health,prevalence of chronic diseases,and awareness level of the hierarchical diagnosis and treatment system (P ＜0.05),but not by gender,age,marital status,and time needed to go to the nearest community health service institution on foot (P ＞ 0.05).By multivariate Logistic regression analysis,the identified associated factors for seeking first contact care delivered by community health institutions in community residents consisted of education level,average monthly income and medical expenses of the preceding year,and awareness level of the hierarchical diagnosis and treatment system (P ＜ 0.05).Conclusion The rate of seeking medical services and that of receiving first contact care delivered by community health institutions in community residents in Xuzhou should be improved.Education level,average monthly income and medical expenses of the preceding year,and awareness level of the hierarchical diagnosis and treatment system are the associated factors for seeking first contact care delivered by community health institutions in these residents.关键词
分级诊疗/市区人口/社区首诊/影响因素分析/徐州Key words
Hierarchical diagnosis and treatment system/Urban population/First contact care in community/Root cause analysis/Xuzhou分类
医药卫生引用本文复制引用
苗春霞,卓朗,李寒寒,王问海,姜金星,郑娟,黄文昊,李秋粟,赵世鸿..分级诊疗制度下徐州市社区居民的社区卫生服务机构首诊情况及影响因素研究[J].中国全科医学,2017,20(25):3104-3108,5.基金项目
2015年江苏省社科基金项目(15GLB012) （15GLB012）
2014年度教育部人文社科项目(14YJC880046) （14YJC880046）
2014年度江苏高校哲学社会科学研究项目(2014SJB415) （2014SJB415）
