上海市居民社区卫生服务利用调查及影响因素分析

Survey on utilization of community health services and influential factors for residents in Shanghai

目的调查上海市居民对社区卫生服务的实际利用情况并分析其影响因素。方法采用随机整群抽样方法,以上海市静安区、长宁区、浦东新区和宝山区作为样本单位,发放自编问卷,就4个区居民对社区卫生各项服务的利用情况进行调查,回收问卷进行描述性统计,分析影响因素。结果共发放问卷3 600份,回收有效问卷3 187份,问卷回收有效率为88.53%。居民社区卫生服务的综合利用率为80.9%,其中女性、老年人、离退休人员及低文化程度、中低收入、丧偶、国有或集体企业及有医疗保险(医保)或社会保险(社保)居民的利用率较高。居民在社区卫生服务中心利用最多的单项服务是看病就诊(62.1%)和配药(21.7%);预防保健、健康教育与咨询、体检、康复等项目的利用率均不足20%。结论上海市社区居民对社区卫生服务的认知及利用程度较高,但仍有部分服务项目利用不足;居民年龄、文化程度和经济收入是影响社区卫生服务利用的主要因素。

Objective To investigate the utilization of community health services for residents in Shanghai,and analyse the influential factors. Methods Cluster random sampling was adopted to enroll residents in Jing＇an District,Changning District,Pudong New Area and Baoshan District of Shanghai to investigate the utilization of community health services,and self-designed questionnaires were recovered for descriptive statistics and influential factor analysis. Results A total of 3 187 out of 3 600 questionnaires were recovered,with the effective rate of 88.53%.The comprehensive utilization rate of community health services for residents in Shanghai was 80.9%.The females,elderly,retirees,those with low education level,low income,spouse loss,medical insurance or social insurance,and those who served in state-owned enterprises or collective enterprises had higher utilization rates of community health services.Medical treatment and medicine purchase were the items of services most frequently used（62.7% and 21.7%,respectively）,while the utilization rates of health protection,health education,health examination and rehabilitation were less than 20%. Conclusion Comprehensive utilization of community health services is favorable for residents in Shanghai,while there are some items of services with less utilization.Age,education background and income are major influential factors for utilization of community health services.