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• 论著 •
签约居民对家庭医生签约服务连续性的评价
及其影响因素研究
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柳松艺,孟文奇,彭海波,姜晓利,李子鑫,于倩倩 ,尹文强,陈钟鸣, 查看原文
孙葵,郭洪伟
【摘要】 背景 家庭医生签约服务自2016年全面推行以来,已取得阶段性成效,进一步的工作开展需要“质”“量”
并重,重点提高居民的服务获得感和满意度,而目前居民对家庭医生签约服务连续性的评价尚不明确。目的 了解签
约居民对家庭医生签约服务连续性的评价,探讨其影响因素并提出改进策略。方法 于 2021 年 1 月,采用多阶段分
层随机抽样法在山东省菏泽市抽取 9 所社区卫生服务机构和 9 所乡镇卫生院的 1 193 例签约居民。采用汉化版基本医
疗质量评估量表(PCAT)的连续性维度对纳入居民展开入户调查,量表共包含 15 个条目。比较不同特征签约居民的
PCAT 连续性维度得分,采用多元线性回归分析签约居民 PCAT 连续性维度得分的影响因素。结果 共回收有效问卷
1 098 份,问卷有效回收率为 92.04%。其中,签约社区卫生服务机构的居民 541 例(49.27%),签约乡镇卫生院的居
民 557 例(50.73%)。签约居民的 PCAT 连续性维度平均得分为(3.38±0.51)分。得分最高的条目是“D5 您的家庭
医生是否耐心听您叙述病情”,为(3.64±0.59)分;得分最低的条目是“D15 如果很容易给您换一个家庭医生,您是
否愿意”,为(2.98±0.92)分。多元线性回归分析结果显示,签约机构类型、年龄、受教育程度、婚姻状况、职业、
是否患慢性病是签约居民 PCAT 连续性维度得分的影响因素(P<0.05)。结论 签约居民对家庭医生签约服务的连续性
评价总体较好,医患双方建立了长久、稳定的联系。在开展家庭医生签约服务时,应关注签约居民的年龄、受教育程度、
婚姻状况、职业及慢性病患病情况,以针对性提供其所需要的家庭医生签约服务,提高其对家庭医生签约服务的评价。
【关键词】 家庭医疗保健服务;家庭医生签约服务;社区卫生服务;医患关系;连续性;健康服务评估;基本
医疗质量评估量表
【中图分类号】 R 161 R 197 【文献标识码】 A DOI:10.12114/j.issn.1007-9572.2022.0519
柳松艺,孟文奇,彭海波,等 . 签约居民对家庭医生签约服务连续性的评价及其影响因素研究[J]. 中国全科医学,
2022,25(34):4312-4317.[www.chinagp.net]
LIU S Y,MENG W Q,PENG H B,et al. Contracted residents' evaluation for continuity of contracted family doctor
services and influencing factors[J]. Chinese General Practice,2022,25(34):4312-4317.
Contracted Residents' Evaluation for Continuity of Contracted Family Doctor Services and Influencing Factors LIU
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Songyi,MENG Wenqi,PENG Haibo,JIANG Xiaoli,LI Zixin,YU Qianqian ,YIN Wenqiang,CHEN Zhongming,SUN
Kui,GUO Hongwei
School of Management,Weifang Medical University,Weifang 261053,China
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Corresponding author:YU Qianqian,Professor;E-mail:yqq_7921@163.com
【Abstract】 Background Since the full implementation of contracted family doctor services in 2016,we have
achieved phased results. Further work needs to be paid equal attention to "quality" and "quantity",focusing on improving the
residents' sense of service access and satisfaction,however,at present,the residents' evaluation of contracted family doctor
services is not clear. Objective To investigate the contracted residents' evaluation for the continuity of family doctor contract,
explore its influencing factors,and propose improvement strategies. Methods This study used a multi-stage stratified random
sampling method to select 1 193 contracted residents from 9 community health service institutions and 9 township health centers
in Heze City,Shandong Province in January 2021. A household survey was conducted on the included residents by using the
continuity dimension of the Chinese version of the Primary Care Assessment Tools(PCAT),which contains 15 items. We
compared the PCAT-continuity dimension scores of contracted residents with different characteristics,and used multiple linear
regression to analyze the factors influencing the PCAT-continuity dimension scores of contracted residents. Results A total
of 1 098 valid questionnaires were collected,with a valid response rate of 92.04%. 541(49.27%)of them were contracted to
基金项目:国家自然科学基金资助项目(71804130)
261053 山东省潍坊市,潍坊医学院管理学院
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通信作者:于倩倩,教授;E-mail:yqq_7921@163.com
本文数字出版日期:2022-09-29