中国全科医学2018，Vol.21Issue(4)：401-406,6.DOI:10.3969/j.issn.1007-9572.2018.04.006
社区居民对家庭医生签约服务的认知与意愿研究
Community Residents' Awareness and Willingness towards Contractual Services from Family Doctors
摘要
Abstract
Objective To investigate community residents' awareness and willingness towards contractual services from family doctors. Methods In December 2013, using multistage random sampling, we selected 3 040 community residents from 10 neighborhoods/townships in Changning District, Shanghai, and surveyed them using a questionnaire designed by our research group for collecting the data about socio-demographic characteristics, awareness of community health service centers (CHSCs), awareness of family doctors, status of contract signing, as well as intention and associated factors of signing a contract with family doctors among those did not sign. Data were analyzed for 2 750 who returned responsive questionnaires. Then, in June 2016, we conducted a follow-up survey among these residents with the same questionnaire, among whom 2 004 responded validly. Results Compared with 2013, the awareness level of the difference between CHSCs and secondary /tertiary hospitals in the residents was differernt with 2016 (P<0.05). To be specific, higher proportion of residents (83.1%, 1 653/1 989) in 2016 knew that CHSCs are different from secondary /tertiary hospitals, among them, 28.7% (474/1 653) considered that the main difference between CHSCs and secondary/tertiary hospitals was levels of skills and techniques, and the latter had higher level; 37.5% (620/1 653) thought that the difference lay in their scope of treatment, i.e., the secondary/tertiary hospitals mainly treat difficult miscellaneous diseases while CHSCs mainly treat common and frequently-occurring diseases. In 2016, 83.9% (1 681/2 004) of residents knew family doctors, and 67.1% (1 345/2 004) knew that family doctors can provide contractual services, and both rates were higher compared with 2013 (P<0.05). The rate of signing contracts with family doctors was 32.5% (651/2 004) in 2016, which was also higher than that in 2013 (P<0.05). In 2016, 27.9% (374/1 339) of the unattached residents had the intention of signing, and the three leading factors that affected the willingness to sign include lack of demand for family doctor services (45.3%, 437/965), worrying that they could not access to the services delivered by other medical institutions after being attached to the designated medical institutions (13.1%, 126/965), and thought that the professional skills of family doctors were low (9.4%, 91/965). Conclusion Community residents have a good understanding of CHSCs and family doctors, but the level needs to be deepened and their willingness to sign contracts with family doctors needs to be improved. In view of this, family doctor services should be publicized intensively, capabilities of family doctors and standards of their services should be improved, and their valuable contractual services should be promoted.关键词
家庭医生签约服务/认知/意愿/居民Key words
Family doctor contractual services/Cognition/Willingness/Residents分类
医药卫生引用本文复制引用
王良晨,葛敏,江萍,朱敏杰,赵新平,梁鸿,黄蛟灵,刘姗姗,张宜民..社区居民对家庭医生签约服务的认知与意愿研究[J].中国全科医学,2018,21(4):401-406,6.基金项目
国家自然科学基金资助项目(71403171) （71403171）
上海市浦东新区卫生和计划生育委员会学科带头人计划项目(PWRd2014-13) （PWRd2014-13）
上海市浦东新区卫生、计生科技项目(PW2016A-3) （PW2016A-3）
