中国农村卫生事业管理2024，Vol.44Issue(8)：538-543,6.DOI:10.19955/j.cnki.1005-5916.2024.08.002
基于多水平模型的家庭医生签约影响因素研究
Factors affecting the willingness to sign family doctor contracted services using multi-level generalized hierarchical model
摘要
Abstract
Objective To assess the willingness of rural residents in Shandong Province to engage with family doctors and to explore associated determinants,thereby providing policy recommendations for the successful implementation of family doctor contracted services in rural areas of Shandong Province.Methods A question-naire survey was conducted in six randomly selected counties in Shandong Province,employing a multi-level gener-alized hierarchical linear model to explore influencing factors.Results Among 2978 residents in Shandong Prov-ince who were approached for family doctor contracting,27.73％had engaged in such contracts.Regression ana-lyses results revealed that at the individual level,rural residents with higher education(high school and above:OR=1.71,P=0.001),regular physical exercise(OR=1.40,P=0.001),presence of multiple chronic disea-ses(OR=1.53,P=0.006)were more willing to contract with family doctors;at the village level,clinics with higher degrees of informatization had higher signing rates;and at the town level,health centers with sufficient a-vailability of essential medications(OR=1.53,P=0.032),higher degree of informatization(OR=1.28,P=0.005),and with doctors having family doctor training(OR=3.19,P=0.002)and central hospitals(OR=1.92,P＜0.001)had greater signing probabilities.Conclusions It is recommended to enhance publicity of fami-ly doctor contracted services among residents,improve their health literacy,achieve equitable allocation of health-care resources,elevate overall standards of primary healthcare services,and encourage rational healthcare-seeking behaviors among residents,so as to augment family doctor signing rates and operational efficiency.关键词
家庭医生/签约服务/影响因素/乡村医生/基层医疗机构/多水平广义分层模型/农村Key words
Family doctor/Contracted services/Influencing factor/Village doctor/Primary healthcare institution/Multi-level generalized hierarchical model/Rural area分类
医药卫生引用本文复制引用
傅佩佩,孙懿泓,周成超..基于多水平模型的家庭医生签约影响因素研究[J].中国农村卫生事业管理,2024,44(8):538-543,6.基金项目
国家自然科学基金项目(72204147) （72204147）
