关键词: 卫生保健改革, 社区卫生服务, 症状, 数据收集

Abstract: Objective　To investigate the effect of China's healthcare reform on the preferred health facility for initial consultation for common medical symptoms among residents in Beijing's Yuetan area，providing a scientific basis for the development of hierarchical medical system and initial consultation system in primary care.Methods　From January to April 2017，we conducted a survey in a random sample of 829 permanent residents aged 15 or over in Yuetan area with a self-designed questionnaire for collecting the data about the community health center as the preferred health facility for initial consultation for 17 common medical symptoms （cold，fever，dizziness，headache，palpitation，chest tightness and pain，suffocation and wheezing，abdominal pain，diarrhea，acid reflux，vomiting，constipation，fatigue，low back pain and arthralgia，edema of lower extremity，insomnia，frequent urination） before the implementation of healthcare reform （April 8，2017） and after the implementation of the first round of healthcare reform （increasing the financing for medical service fee，cancellation of the registration fee，adjusting the examination fee） as well as the second round of healthcare reform （increasing the categories of drugs used in community health organizations）.Results　 809 returned responsive questionnaires，achieving a response rate of 97.6%.Compared with before the healthcare reform，after the implementation of two rounds of healthcare reform，the proportion of residents preferred community health centers （CHCs） for initial consultation for the aforementioned 17 medical symptoms increased significantly （P<0.01）.Moreover，compared with after the implementation of the first round of healthcare reform，CHCs were selected for initial consultation by higher proportion of residents for palpitation，chest tightness and pain，fatigue，low back pain and arthralgia and edema of lower extremity，but by lower proportion of residents for suffocation and wheezing after the implementation of the second round of healthcare reform （P<0.01）.Conclusion　After the implementation of the two rounds of healthcare reform，Yuetan residents were more likely to have the initial consultation in CHCs when they developed the common medical symptoms.

Key words: Health care reform, Community health services, Symptoms, Data collection