区域医联体模式下医护人员参与国家基本公共卫生服务意愿影响因素分析

Analysis of influencing factors of medical staff’s willingness to participate in national basic public health services under the regional medical consortium model

目的区域医联体内医院专科护士参与社区慢性传染性疾病随访工作意愿率远没有达到预期目标。本研究分析区域医联体模式下综合医院医护人员参与国家基本公共卫生服务意愿及影响因素,为基本公共卫生服务均等化提供理论依据。方法自制调查问卷,于2019-04-01—06-30对285名区域医联体内医院医护人员进行调查,包括基本情况、基本公共卫生服务内容、参与愿意及影响因素等内容。结果33.33%医护人员愿意从事国家基本公共卫生服务工作,首要原因是"知晓基本公共卫生"和"职业前途"。单因素分析显示,基本公共卫生服务知晓得分(χ~2=118.775,P<0.001)、年龄(χ~2=19.203,P<0.001)、职称(χ~2=18.719,P<0.001)、岗位(χ~2=8.148,P<0.001)、服务机构医联体内地位(χ~2=54.678,P<0.001)与医护人员参与社区基本公共卫生服务工作意愿有关联。多因素分析显示,基本公共卫生服务知晓得分(OR=19.432,95%CI为9.052~41.715,P<0.001)、年龄(OR=3.806,95%CI为1.813~7.993,P<0.001)、职称(OR=3.073,95%CI为1.412~6.687,P<0.001)、岗位(OR=2.403,95%CI为1.139~5.072,P=0.004)和服务机构医联体内地位(OR=2.163,95%CI为1.009~4.635,P<0.001)是医护人员参与国家基本公共卫生服务意愿的影响因素。结论基本公共卫生服务知晓、年龄、职称、岗位和服务机构医联体内地位是医护人员参与国家基本公共卫生服务意愿的影响因素。

OBJECTIVE The willingness rate of specialist nurses in the regional medical federation hospitals to participate in the follow-up of chronic infectious diseases in the community has fallen far short of expected goals.This study analyzes the willingness and influencing factors of medical staff in general hospitals to participate in national basic public health services under the regional medical consortium model,and provides a theoretical basis for the equalization of basic public health services.METHODS A self-made questionnaire survey was conducted on 285 regional medical federation hospital medical staff from April 1 to June 30,2019,including basic information,basic public health services,willingness to participate,and influencing factors.RESULTS Totally 33.33%of medical and nursing staff were willing to engage in national basic public health services.The main reasons were"knowledge of basic public health"and"professional future".Univariate analysis showed that basic public health services were known(χ~2=118.775,P<0.001),age(χ~2=19.203,P<0.001),job title(χ~2=18.719,P<0.001),position(χ~2=8.148,P<0.001),the internal status of the medical institution’s medical association(χ~2=54.678,P<0.001)is related to the willingness of medical staff to participate in the community’s basic public health services.Multivariate analysis showed that basic public health services were known(OR=19.432,95%CI:9.052-41.715,P<0.001),age(OR=3.806,95%CI:1.813-7.993,P<0.001),job title(OR=3.073,95%CI:1.412-6.687,P<0.001),position(OR=2.403,95%CI:1.139-5.072,P=0.004),and internal status of the medical association of the service organization(OR=2.163,95%CI:1.009-4.635,P<0.001)were the influence of medical personnel’s willingness to participate in the country’s basic public health services factor.CONCLUSION Awareness of basic public health services,age,title,position and service organization’s internal health status are influential factors for the willingness of medical personnel to participate in national basic public health services.