中国全科医学 ›› 2023, Vol. 26 ›› Issue (19): 2369-2375.DOI: 10.12114/j.issn.1007-9572.2022.0685

所属专题: 中医最新文章合集 健康公平性最新文章合集

• 论著·基层卫生服务研究 • 上一篇    下一篇

重庆市主城区居民社区中医药服务利用情况及影响因素研究

郭黛瑶, 蒲川*(), 彭杨, 邱岚, 胡歆瑀   

  1. 401331 重庆市,重庆医科大学公共卫生学院 医学与社会发展研究中心
  • 收稿日期:2022-09-26 修回日期:2023-03-14 出版日期:2023-07-05 发布日期:2023-03-24
  • 通讯作者: 蒲川

  • 作者贡献:郭黛瑶提出研究选题方向,并负责后期数据分析与原稿写作;蒲川负责文章的质量控制及审校,对文章整体负责;彭杨、邱岚、胡歆瑀负责前期调查开展与数据收集,对文稿进行修订。
  • 基金资助:
    重庆市技术预见与制度创新项目(cstc2021jsyj-zzysbAX0066)

Utilization of Traditional Chinese Medicine Community Services and Influencing Factors by Residents in the Main Urban Areas of Chongqing

GUO Daiyao, PU Chuan*(), PENG Yang, QIU Lan, HU Xinyu   

  1. Research Center for Medicine and Social Development/School of Public Health, Chongqing Medical University, Chongqing 401331, China
  • Received:2022-09-26 Revised:2023-03-14 Published:2023-07-05 Online:2023-03-24
  • Contact: PU Chuan

摘要: 背景 随着老龄化日趋严重、居民疾病谱发生转变,国家对基层中医药事业的发展日益重视。了解居民对社区中医药服务的利用现况及影响因素,对未来更好地发挥出社区中医药服务应有的价值起着关键作用。 目的 从需方角度了解重庆市主城区居民对社区中医药服务的利用现状及影响因素,为社区中医药服务可持续发展提供参考。 方法 于2021-12-01在重庆市9个中心城区采用配额抽样法按人口比例抽取23家社区卫生服务中心,采用偶遇抽样法在每家社区卫生服务中心及其周边社区抽取居民展开问卷调查。实际发放问卷840份,有效问卷806份,有效率为96.0%。基于安德森卫生服务利用行为分析框架将影响个人服务利用行为的因素归纳为倾向特征、使能资源和需求要素三类,同时新增个人中医文化维度,采用二元Logistic回归分析4个维度因素对居民社区中医药服务利用的影响。 结果 受访居民对社区中医药服务的利用率仅为35.9%(289/806)。倾向特征(年龄、婚姻状况)、使能资源(医保类型、近2周个人医疗支出、机构能否满足家庭基本医疗需求、机构是否提供中医药服务)、需要因素(是否患慢性病、近2周自觉身体状况、是否需要社区中医药服务)、个人中医文化(中医转诊意愿、中医药文化相信程度、社区中医药文化氛围)共4个层面12个指标是居民利用社区中医药服务的影响因素(P<0.05)。 结论 居民社区中医药服务的利用受到多维度、多因素的影响,故而应采取针对性的措施促进居民对社区中医药服务的利用。

关键词: 社区卫生中心, 中医药疗法, 卫生服务利用不足, 影响因素分析, 重庆

Abstract:

Background

With the increasing aging and the transformation of the disease spectrum of residents, there is increasing national attention to the development of Traditional Chinese Medicine (TCM) services. It is of great significant in better utilizing the proper value of TCM community services in the future to understand the current situation and influencing factors of TCM community services utilization.

Objective

To understand the current situation and influencing factors of TCM community services utilization among residents in the main urban areas of Chongqing from demander's perspective, so as to provide reference for the sustainable development of TCM community services.

Methods

On December 1, 2021, 23 community health service centers were selected by quota sampling method in proportion to the population in 9 central urban areas of Chongqing, and the residents in each community health service center and its surrounding communities by incidental sampling method were selected to conduct questionnaire surveys. The actual number of questionnaires distributed was 840 with 806 valid questionnaires and effective rate of 96.0%. Based on Anderson's health service utilization behavior analysis framework, the factors influencing individual service utilization behavior were summarized into three categories: tendency characteristics, enabling resources and demand factors. At the same time, the dimension of personal TCM culture was added. Binary Logistics regression was used to analyze the influence of the four dimensions on the utilization of TCM in the community.

Results

The utilization rate of TCM community services among the surveyed residents was only 35.9% (289/806), 12 indicators in 4 dimensions were associated with the TCM community services utilization, including propensity characteristics (age, marital status), enabling resources (type of medical insurance, medical expenditure in the last 2 weeks, whether the institutions can meet the basic medical needs of families, whether institutions provide TCM services), demand factors (chronic diseases, self-perception of physical condition in 2 weeks, demand for TCM community services), personal TCM culture (TCM referral willingness, TCM culture trust level, community TCM cultural atmosphere) (P<0.05) .

Conclusion

There are multidimensional and multifactorial influences on the TCM community services utilization among residents. Therefore, targeted measures should be taken to promote residents' utilization of TCM community services.

Key words: Community health centers, Traditional Chinese medicine therapy, Health services underutilization, Root cause analysis, Chongqing