Abstract: Objective　To explore the role of the healthcare department of neighborhood centers in the promotion of family doctor services.Methods　We conducted this study from January to April 2017.Using simple random sampling with a sampling fraction of 1∶10，we selected totaled 1 502 registered residents seeking outpatient treatment（725 from the healthcare department，Jixiangfang Neighborhood Center，Minhang District Maqiao Community Health Center，362 from Qizhong Health Station，415 from Linsong Health Station）.Then we conducted a survey among them with a self-developed questionnaire for collecting the data about demographic characteristics，awareness of family doctor services，status of signing a contract with the family doctor，initial consultation with the family doctor and making an appointment with the family doctor，level of satisfaction with the family doctor service，as well as the level of trusting the family doctor services.Results　A total of 1 451（96.6%）participants〔703 from the healthcare department，Jixiangfang Neighborhood Center（healthcare department of neighborhood center group），748 from the two health stations（health station group）〕 were included in the final analysis.Compared with the health station group，healthcare department of neighborhood center group demonstrated higher rate of signing a contract with the family doctor 〔33.9%（238/703）vs 28.6%（214/748）〕，higher rate of having initial consultation with the family doctor〔68.7%（483/703）vs 63.8%（477/748）〕，and higher rate of making an appointment with the family doctor〔50.5%（355/703）vs 45.2%（338/748）〕（P<0.05）.Furthermore，healthcare department of neighborhood center group showed higher levels of satisfaction with the overall family doctor services，convenience in seeking healthcare，home-based care，service attitude，health education，and psychological counseling，and higher levels of trusting doctor attending to their needs，their willingness to participate in therapy，the doctor being honestly liable for medical mistakes，the doctor keeping patient-doctor conversations with complete confidentiality（P<0.05）.However，healthcare department of neighborhood center group and health station group showed no significant difference in the awareness of family doctor services〔93.2%（655/703） vs 90.6%（678/748）〕（P>0.05）.Moreover，both groups exhibited similar levels of satisfaction with the waiting time for consultation，vaccination service，and regular physical examination，and similar self-perceived doctors' attention level，self-perceived level of best efforts used by the doctor during management，level of adherence to doctors' advice，levels of trust in the matters informed by the doctor，management delivered by the doctor，and professional capabilities of the doctor（P>0.05）.Conclusion　The healthcare department of the neighborhood center plays an important role in improving the level of satisfaction with family doctor services and level of trusting such services in the residents.However，the rate of signing a contract with the family doctor and rate of having initial consultation with the family doctor in the residents under management should be improved further.

Key words: Neighborhood center, Family doctor services, Satisfaction, Trust

摘要： 目的　了解邻里中心卫生单元对家庭医生式服务的作用效果。方法　在2017年1—4月闵行区马桥社区卫生服务中心下设“吉祥坊”邻里中心卫生单元、旗忠卫生服务站、临松卫生服务站门诊登记在册的就诊居民中，按照10∶1的比例，采用简单随机抽样法抽取居民725、362、415例，分别作为邻里中心卫生单元组、社区卫生服务站组。采用自行设计的问卷对居民进行调查，主要内容包括居民对家庭医生式服务的知晓、签约情况，基层首诊、预约情况，对家庭医生式服务的满意度和信任度。共发放问卷1 502份，回收有效问卷1 451份（邻里中心卫生单元组703份、社区卫生服务站组748份），问卷有效回收率为96.60%。结果　邻里中心卫生单元组、社区卫生服务站组居民对家庭医生式服务的知晓率分别为93.2%（655/703）、90.6%（678/748），签约率分别为33.9%（238/703）、28.6%（214/748），基层首诊率分别为68.7%（483/703）、63.8%（477/748），就诊预约率分别为50.5%（355/703）、45.2%（338/748）。两组知晓率比较，差异无统计学意义（P>0.05）；邻里中心卫生单元组的签约率、基层首诊率、就诊预约率高于社区卫生服务站组，差异有统计学意义（P<0.05）。邻里中心卫生单元组对家庭医生式服务的总体满意度及对就医便捷、上门诊疗、服务态度、健康宣教、心理咨询的满意度高于社区卫生服务站组，差异有统计学意义（P<0.05）；两组对排队等候、免疫预防、定期体检的满意度比较，差异无统计学意义（P>0.05）。邻里中心卫生单元组对家庭医生重视自己需求、医生重视自己医疗意愿、医生出错时坦诚方面的得分高于社区卫生服务站组，在不信任医生建议、医生对谈话内容保密性差方面的得分低于社区卫生服务站组，差异有统计学意义（P<0.05）；两组在感觉医生不关心自己、听从医生建议、信任医生告知内容、信任医生的诊治、医生诊治不尽力、医生技术水平高方面的得分比较，差异无统计学意义（P>0.05）。结论　邻里中心卫生单元的开展较好地提高了居民对家庭医生式服务的满意度及信任度，但居民的家庭医生式服务签约率、基层首诊率仍有待提高。

关键词: 邻里中心, 家庭医生式服务, 满意度, 信任度