盘锦市居民社区首诊意愿及影响因素分析

Study on the willingness and influencing factors of the community first consultation of residents in Panjin City

目的了解盘锦市居民社区首诊意愿,并探讨其影响因素。方法2018-07-03-2018-08-03,采用省项目组定制的调查问卷对盘锦市兴隆台区6个社区卫生服务中心≥18岁常驻居民进行问卷调查,内容包括居民基本情况、就医情况、社区首诊意愿以及居民选择医疗机构进行医疗器械检查的倾向。采用单因素及多因素Logistic回归分析居民社区医院首诊意愿的影响因素。结果825名社区居民中有379名(45.94%)居民选择愿意在社区医院首诊,有446名(54.06%)居民选择不愿意在社区医院首诊。居民不愿意到基层医疗机构就诊的首要原因为认为基层医疗机构技术水平比大医院差(34.30%)。单因素分析结果显示,年收入(χ2=59.432,P=0.001)、文化程度(χ2=83.503,P=0.001)和自评健康状况(χ2=44.469,P=0.001)对居民社区首诊意愿有影响。多因素Logistic回归分析结果显示,文化程度越高(OR=1.311,95%CI为1.145~1.502,P=0.001)、家庭年收入越高(OR=1.277,95%CI为1.056~1.544,P=0.012)和自评健康状况越差(OR=1.448,95%CI为1.127~1.860,P=0.004)的居民,选择社区医院首诊的意愿越低。结论盘锦市居民社区首诊意愿较低,居民收入水平、文化程度和自评健康状况是居民社区首诊意愿的影响因素。

Objective To understand the willingness of residents in Panjin City to visit the community for the first time,and explore its influencing factors.Methods From July to August 2018,aquestionnaire customized by the provincial project team was used to conduct a questionnaire survey on resident residents≥18 years old under the jurisdiction of 6 community health service centers in Xinglongtai District,Panjin City.The content included basic residents’information,medical treatment,and the willingness of first consultation and residents’tendency to choose medical institutions for medical device inspection.Results Among the 825 community residents,379(45.94%)residents chose to be willing to have the first diagnosis in a community hospital,and 446(54.06%)residents chose not to do the first diagnosis in a community hospital.The primary reason for residents’unwillingness to go to primary medical institutions for treatment was that primary medical institutions had a lower technical level than major hospitals(34.30%).There was a statistically significant difference in the first-degree willingness of residents in different income(χ2=59.432,P=0.001),education(χ2=83.503,P=0.001),and self-assessment of health status(χ2=44.469,P=0.001).The results of multivariate logistic analysis showed that the higher the education level(OR=1.311,95%CI:1.145-1.502,P=0.001),the higher the annual family income(OR=1.277,95%CI:1.056-1.544,P=0.012)and the poorer the self-rated health status(OR=1.448,95%CI:1.127-1.860,P=0.004),the lower the willingness to choose the first diagnosis in the community hospital.Conclusions The willingness of the first consultation in the community of residents is relatively low in Panjin City.And income level,educational level and self-assessed health status are the factors that influence the residents’willingness to make first consultation.