上海市社区居民就医行为和影响因素分析(一)

Analysis on Intention of Visiting Doctor and Affecting Factors in Community Residents of Shanghai

目的对上海市某社区居民就医意向和影响因素进行分析,了解居民医疗需求,指导医院提供满足社区居民需要的卫生服务,提供改善居民就医行为的依据。方法采用自行编制的调查问卷,内容包含有居民性别、年龄、经济收入、文化程度等一般情况。由经过培训的医护人员,在社区居委会协助下进行发放、填写。调查对象为2006年8月-12月居住某社区半年以上、具有行为意识能力、愿意接受调查的居民,共1200名,占社区居民人口的1%。结果有效问卷1179份。78.20%的居民选择综合性医院就诊,主要是医疗技术原因;不选择综合性医院的原因中"等候时间太长"占第一位,为45.51%;选择社区医院的原因中"交通便捷"是主要原因,占41.38%,其次为"价格便宜",为25.23%;不选择社区医院的原因中认为"技术不够"的占72.77%。分层分析发现,60岁以上的老年人、大学以上学历人员就医选择综合性医院就诊的比例较高。结论社区居民受就医医院的医疗质量、技术水平因素影响。要重视老年居民的医疗行为和影响因素,大力发展社区卫生服务,正确引导居民就医,解决看病难、看病贵的问题。

Objective To analyze intention of visiting doctor and affecting factors in community residents of shanghai, investigate the medical demand of residents, guide hospitals to satisfy the needs for medical services, and provide the basis for improving health seeking behavior of community residents. Methods The survey on intention of visiting doctor and affecting factors was carried out in 1 200 community residents （ account for 1% ） from Aug. 2006 to Dec. 2006 with self-made questionnaire. All the questionnaires were handed out, filled in and collected with the assistance of occupational medical staff and community committee. Results 1 179 questionnaires were eligible. 78.20% of residents choose to superior hospital because of their high level of medical technology;the long waiting time was the main reason for not choosing superior hospital （45.51% ）. The convenient traffic was the first reason for choosing community hospital （41.38%）, followed by the medical expenses;the technology level leaded to 72.77% of residents did not choosing the community hospital. The senile patients over 60 years old and those that had bachelor degree preferred to superior hospital. Conclusion Medical service quality and technique are main factors on choosing medical institutions. More attention should be paid to elders. Community health service centers should play a more important role in the goal of taking advantage of medical resources, and guide health seeking behavior of residents.