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签约服务对基层医疗卫生机构高血压患者血压控制效果和就诊满意度的影响研究——基于10省现况调查
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| 投稿时间： 2015-03-11 最后修改时间： 2015-05-08 摘要点击次数: 2683 全文下载次数: 1505 |
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| 引用本文：殷涛,尹德卢,秦坤,等.签约服务对基层医疗卫生机构高血压患者血压控制效果和就诊满意度的影响研究——基于10省现况调查[J].中国卫生政策研究,2015,8(6):46-51 |
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| 殷涛1 |
1. 首都儿科研究所 北京 100020;
2. 国家卫生计生委体改司 北京 100044;
3. 成都中医药大学 四川成都 611137;
4. 中国社区卫生协会 北京 100020;
5. 北京师范大学 北京 100875;
6. 上海社区卫生协会 上海 200000;
7. 北京市社区卫生服务管理中心 北京 100053 |
| 基金项目:世界银行“中国经济改革实施项目”子项目 (TCC5-A29-12) |
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| | 摘要:目的:探讨签约服务对基层医疗卫生机构高血压患者管理效果和满意度的影响。方法:使用项目组自行设计的调查问卷,对10省20家基层医疗卫生机构就诊的签约和未签约高血压患者进行现况调查。结果:40~50岁、公费医疗、“小”病就医在社区卫生服务机构和乡镇卫生院、签约的调查对象自报血压控制效果更好(P<0.05)。参加城镇居民医疗保险、“小”病就医首选社区卫生服务机构和签约的患者对医务人员的满意度更高(P<0.05)。在评价签约和血压控制效果及满意度之间关系的有序多分类logistic回归方程中,校正了年龄、性别、文化程度、医疗保险方式、“小”病就医首选机构等因素的影响之后,签约是血压控制效果的独立影响因素,OR=3.007(95% CI:2.572-3.517),同样校正了上述因素的影响之后,签约与满意度呈正关联,OR=1.814(95% CI:1.563-2.105)。结论:签约是社区高血压患者血压控制效果和就诊满意度的独立影响因素,签约患者血压控制效果和就诊满意度均高于非签约患者。 | |
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关键词:全科医生 签约服务 管理效果 影响因素
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| Effect of sign-contract service on blood pressure control and patients satisfaction of hypertensive patients in primary health centers: Based on investigation in 10 provinces |
| YIN Tao1 |
1. Capital Institute of Pediatrics, Beijing 100020, China;
2. National Health and Family Planning Commission of the People's Republic of China, Beijing 100044, China;
3. Chengdu University of TCM, Chengdu Sichuan 611137, China;
4. Community Health Association of China, Beijing 100020, China;
5. Beijing Normal University, Beijing 100875, China;
6. Community Health Association of Shanghai, Shanghai 200000, China;
7. Community Health Management Center of Beijing, Beijing 100053, China |
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| | Abstract:Objective: To investigate the effects of sign-contract services on hypertension patient disease control and the satisfaction of medical staff. Methods: a face-to-face questionnaire survey was conducted among hypertension patients selected from 20 primary health centers in 10 provinces in China. Results: This paper collected 1,881 valid questionnaires, and the average age of the population was 65.72±10.88. Respondents that received sign-contract services accounted for 53.88%, and there was no difference between patients who signed the service contract and who did not in terms of demographics. In self-reporting of blood pressure controls, respondents who signed the service contract, aged 40～50 years old, enjoyed the free medical care, preferred to seek medical services from primary agencies (i.e. community health centers and township hospitals) for minor illnesses, controlled their blood pressure better (P<0.05). Respondents enjoyed the civil resident medical insurance, preferred to seek medical care from community health centers for minor illnesses and signed the service contract were more likely to be satisfied with their medical practitioner (P<0.05). After adjusting for age, gender, education level, medical insurance style, patient willingness to seek medical care for minor illnesses, signing service contracts was found to be an independent factor both associated with blood pressure self-control and attitudes towards medical service providers, with the odds ratio of 3.007 (95%CI: 2.572-3.517) and 1.814 (95%CI: 1.563-2.105) respectively. Conclusion: Contracts are correlated with blood pressure control and satisfaction toward medical practitioners, which means that patients who signed the service contract control their blood pressure better and are more satisfied with their medical deliverers. | |
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