关键词: 基层医疗卫生机构, 医防整合, 医务人员, 因子分析

Abstract: Background　 The perceptions of integrated medical and preventive services of primary care doctors and nurses，key providers for essential medical and public health services，affects the provision of such services，so it is essential to study their perceptions for formulating and implementing supportive policies of such services. Objective　 To investigate primary care doctors and nurses' subjective perceptions and associated factors of integrated medical and preventive services，providing a reference for the development of integrated medical and preventive care system. Methods　 From April to October 2019，we conducted a survey using a self-developed questionnaire on perception and evaluation of integrated medical and preventive services with questions presented using a Likert scale among a nationwide sample of primary care doctors and nurses selected by multistage sampling. The survey achieved a response rate of 89.5%（725/810）. We used factor analysis to reduce the dimensionality of the 12 variables，extracted and explained the common factors，and calculated factor scores. Results　Factors reflecting subjective perceptions of integrated medical and preventive services were summarized as follows：institutional environment support factor，departmental cooperation and interaction factor，and individual professional boundary factor. The cumulative variance explained by them reached 70.43%. By using a 4-point rating system，the factors of institutional environment support，departmental cooperation and interaction，and individual professional boundary were rated （2.97±0.54），（2.81±0.55） and （2.46±0.65） points，respectively，and the comprehensive perceptions of integrated medical and preventive services were rated （2.86±0.53） points. Conclusion　 According to the subjective perceptions of integrated medical and preventive services of primary care doctors and nurses，the institutional environment support was not high，inter-departmental cooperation was rare，and professional boundary was strong. To build an integrated health care system and achieve accessible integrated medical and preventive services in primary care，related governmental departments should offer more policy support，the cooperation between multidisciplinary professionals should be strengthened，and the thoughts of medical and preventive services being unconnected in primary care doctors and nurses should be changed.

Key words: Primary health care institutions, Integrated medical and preventive services, Medical staff, Factor analysis