| 引用本文：袁莎莎, 王芳, 杜词, 田淼淼, 贾梦, 赵敏捷.基层就诊居民家庭医生签约及首诊行为的影响因素[J].中国卫生政策研究,2020,13(9):40-46 |
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| 基层就诊居民家庭医生签约及首诊行为的影响因素 |
| 投稿时间：2020-07-02 修订日期：2020-08-07 PDF全文浏览 HTML全文浏览 |
| 袁莎莎1, 王芳1, 杜词1,2, 田淼淼1, 贾梦1, 赵敏捷1,2 |
1. 中国医学科学院医学信息研究所 卫生体系与政策研究中心 北京 100020;
2. 北京协和医学院 北京 100730 |
| 摘要:目的：分析基层医疗机构就诊居民签约家庭医生以及签约后首诊行为的影响因素，为进一步推动基层首诊制度提供依据。方法：采用目的抽样，2019年7-10月在东、中、西部三个样本市6家基层医疗机构对就诊居民进行出口调查；采用描述性统计和二元logistic回归分析方法进行数据分析。结果：共调查484名基层就诊居民。logistic回归分析显示，对家庭医生内涵认识正确，对家庭病床服务需求更高，由社区医务人员推荐、居民区宣传栏等方式了解家庭医生的就诊居民更愿意签约；清楚家庭医生提供健康管理服务，医保优惠和长处方政策，签约时间更长的签约居民更倾向于基层首诊。结论：应进一步通过社区医务人员推荐、居民区宣传栏等方式加强居民对家庭医生"健康管理者"内涵的理解，以需求家庭病床的居民为重点对象，促进有效签约；强化签约居民对健康管理服务内容和医保优惠政策的认知，巩固续签意愿。 |
| 关键词:家庭医生 签约 首诊 影响因素 |
| 基金项目:中国医学科学院医学与健康科技创新工程项目（2016-I2M-3-018）；国家卫生健康委基层司委托项目 |
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| Influencing factors on residents' behavior about family doctor contracting service and first contact at primary care |
| YUAN Sha-sha1, WANG Fang1, DU Ci1,2, TIAN Miao-miao1, JIA Meng1, ZHAO Min-jie1,2 |
1. Center of Health System and Policy, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China;
2. Peking Union Medical College, Beijing 100730, China |
| Abstract:Objective:To analyze the affecting factors related to residents' behavior about family doctor contract service and first contact at primary care to provide empirical evidence. Methods:By purposive sampling, the field survey was conducted at six primary health institutions in three sample cities located in the eastern, middle and western parts of China during Jun-Oct 2019. Descriptive statistical analysis and logistic regression analysis were adopted. Results:There were 484 residents in total. It revealed that the residents with the following characteristics were more prone to contract with family doctors, i.e., right understanding of family doctors, higher demanding of family beds, in the way of recommendation by primary health workers and propaganda in the residential area. Further, the contracted residents who were aware of health management services' provision, health insurance benefit policy and long drug prescription policy, contracting longer were more likely to choose primary care as first contact when needed. Conclusions:The following strategies could be adopted to promote future family doctor contract service, that is, selecting the residents with high demanding of family beds as priority group, strengthening the residents' understanding of family doctor and using the way of recommendations of primary health workers and propaganda in the residential area. Further, continue to strengthen the contracted residents' cognition about the provision of health management services and health insurance benefit policy and consolidate their re-contracting willing. |
| Key words:Family doctor Contract First contact Influencing factors |
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