中国全科医学 ›› 2022, Vol. 25 ›› Issue (22): 2773-2781.DOI: 10.12114/j.issn.1007-9572.2022.0010

• 论著·中青年家庭医生签约服务研究 • 上一篇    下一篇

中青年楼宇人群对家庭医生签约服务的需求及影响因素研究

姚岗1, 张诚1, 徐健2, 潘文雷3, 陈晨4, 朱敏5, 王朝昕6, 黄蛟灵6,*()   

  1. 1215400 江苏省太仓市城厢镇社区卫生服务中心
    2215400 江苏省太仓市沙溪镇直塘卫生院
    3215400 江苏省太仓市高新区社区卫生服务中心
    4200040 上海市静安区江宁街道社区卫生服务中心
    5200122 上海市浦东新区潍坊社区卫生服务中心
    6200025 上海市,上海交通大学医学院公共卫生学院
  • 收稿日期:2022-02-11 修回日期:2022-05-24 出版日期:2022-08-05 发布日期:2022-06-23
  • 通讯作者: 黄蛟灵
  • 姚岗,张诚,徐健,等. 中青年楼宇人群对家庭医生签约服务的需求及影响因素研究[J]. 中国全科医学,2022,25(22):2773-2781.[www.chinagp.net]
    作者贡献:姚岗负责文章的构思与设计,撰写论文;徐健、潘文雷、黄蛟灵进行文章的可行性分析;陈晨、朱敏、王朝昕负责文献/资料收集与整理;黄蛟灵负责文章的修订;张诚、黄蛟灵负责文章的质量控制及审校;姚岗、黄蛟灵对文章整体负责。
  • 基金资助:
    国家自然科学基金资助项目(71904145); 上海市科技创新行动计划软科学重点项目(21692190200,22692192300); 上海交通大学医学院科技创新项目-人文社科类(WK2102); 上海交通大学中国医院发展研究院2022年度医院管理建设项目(CHDI-2022-B-31); 上海交通大学新进教师启动计划(19X100040062)

Needs and Associated Factors of Contracted Family Doctor Services in Young and Middle-aged Office Building Occupants

Gang YAO1, Cheng ZHANG1, Jian XU2, Wenlei PAN3, Chen CHEN4, Min ZHU5, Zhaoxin WANG6, Jiaoling HUANG6,*()   

  1. 1Chengxiang Community Health Center, Taicang 215400, China
    2Shaxi Town Zhitang Health Center, Taicang 215400, China
    3High-tech Zone Community Health Center, Taicang 215400, China
    4Jing'an District Jiangning Community Health Center, Shanghai 200040, China
    5Pudong New District Weifang Community Health Center, Shanghai 200122, China
    6School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2022-02-11 Revised:2022-05-24 Published:2022-08-05 Online:2022-06-23
  • Contact: Jiaoling HUANG
  • About author:
    YAO G, ZHANG C, XU J, et al. Needs and associated factors of contracted family doctor services in young and middle-aged office building occupants[J]. Chinese General Practice, 2022, 25 (22) : 2773-2781.

摘要: 背景 建设"健康中国"需要扩大家庭医生签约服务覆盖面,而中青年楼宇人群的家庭医生服务签约率较低。上海市率先探索家庭医生楼宇服务,以需求为导向提供健康管理服务,故研究中青年楼宇人群的健康需求尤为有意义。 目的 了解上海市中青年楼宇人群对家庭医生签约服务的需求,并分析其影响因素。 方法 于2019年12月至2020年12月,在上海市虹口区、浦东新区、静安区选取典型楼宇作为调查点,然后在各楼宇内采用随机整群抽样法抽取中青年人群(18~59岁)进行问卷调查。调查内容包括受试者的社会人口学特征、健康及就诊情况、对家庭医生签约服务的了解,以及对家庭医生签约服务中基本服务和个性化服务的需求情况。采用多元Logistic回归分析中青年楼宇人群家庭医生签约服务需求的影响因素。 结果 共发放问卷2 366份,回收有效问卷2 272份,问卷有效回收率为96.03%。对于家庭医生签约服务中的基本服务,一般有需求/比较有需求/非常有需求者占比为87.65%(1 874/2 138);对个性化服务有需求者占比为70.59%(1 874/2 057)。多元Logistic回归分析结果显示,年龄、受教育程度、自评社会阶层、对自身健康状况了解度、自评健康状况、患慢性病情况、自评心理健康状况、患常见病时首选就诊机构、社区卫生服务机构就诊经历、对家庭医生了解度、对家庭医生信任度、对家庭医生楼宇服务了解度、对家庭医生楼宇服务内容了解度是中青年楼宇人群对家庭医生签约服务中基本服务需求的影响因素(P<0.05);受教育程度、社会医疗保障情况、常用药情况、患慢性病情况、患常见病时首选就诊机构、社区卫生服务机构就诊经历、对家庭医生楼宇服务了解度、对家庭医生楼宇服务内容了解度是中青年楼宇人群对家庭医生签约服务中个性化服务需求的影响因素(P<0.05)。 结论 楼宇人群对于家庭医生签约服务的需求较高,提高人群健康素养,改变宣传策略,提升家庭医生团队和基层医疗卫生机构的服务能力,有利于提高楼宇人群家庭医生服务签约率。

关键词: 家庭医生签约服务, 中青年楼宇人群, 卫生服务需求, 影响因素分析, 上海

Abstract:

Background

For building a healthy China, it is essential to expand the coverage of family doctor services. In young and middle-aged office building occupants, the rate of contracting family doctor services is low. Shanghai has taken the lead in exploring building-based family doctor services, and providing on-demand health management services. So it is particularly meaningful to study the health needs in young and middle-aged office building occupants.

Objective

To investigate the needs and associated factors of contracted family doctor services among young and middle-aged office building occupants in Shanghai.

Methods

A questionnaire survey was conducted from December 2019 to December 2020 with a cluster random sample of young and middle-aged office building occupants (aged 18-59 years) selected from representative office buildings in Shanghai's Hongkou District, Pudong New District, and Jing'an District of Shanghai for understanding their sociodemographic characteristics, health and healthcare-seeking conditions, knowledge of family doctor services, and needs of essential and personalized family doctor services. Multiple Logistic regression analysis was used to analyze the factors affecting the needs of family doctor services.

Results

In all, 2 366 cases attended the survey, and 2 272 of them (96.03%) who completed the survey effectively were included for analysis. Among them, 87.65% (1 874/2 138) had general, moderate or strong needs for essential family doctor services, and 70.59% (1 452/2 057) had needs for personalized family doctor services. Multiple Logistic regression analysis indicated that age, education level, self-assessed social class, understanding of one's own health, self-assessed health status, chronic disease prevalence, mental health status, preferred healthcare setting for treating common diseases, treatment experience in a community health institution, understanding of and degree of trust in a family doctor, and understanding of building-based family doctor services and the specific scope of the services were associated with the needs of essential family doctor services (P<0.05). Education level, social health insurance, commonly used drugs, chronic disease prevalence, preferred healthcare setting for treating common diseases, treatment experience in a community health institution, understanding of building-based family doctor services, and understanding of the scope of building-based family doctor services were associated with the needs of personalized family doctor services (P<0.05) .

Conclusion

The contracted family doctor services were in high demand in young and middle-aged office building occupants. Improving health literacy in this population, modifying publicity strategies regarding the services, and improving the capabilities of the family doctor team and primary medical institutions, may be conducive to increasing the rate of contracting family doctor services in this group.

Key words: Contracted family doctor services, Young and middle-aged office building occupants, Health services needs and demand, Root cause analysis, Shanghai