成都市2008—2012年社区卫生服务居民满意度变化趋势与影响因素研究

Trend of Residents' Satisfaction Change with Community Health Service in Chengdu City from 2008 to 2012 and Its Influencing Factors

目的探讨成都市2008—2012年社区卫生服务居民满意度的变化趋势及影响满意度的主要因素,为进一步提高社区卫生服务质量、更好适应居民需求变化提供参考依据。方法于2008—2012各年的3—4月份,采用方便抽样的方法,在成都市6个中心城区的社区卫生服务机构出口处对社区居民进行拦截调查。采用"重点联系城市社区卫生服务体系建设"项目中的满意度调查问卷,采用结构式访谈方法询问调查对象,调查问卷的内容包括调查对象的人口学特征、对社区卫生服务的利用情况、对社区卫生服务的满意度。实际调查人数为2008年600人,2009年503人,2010年604人,2011年602人,2012年601人,5年共计2 910人。结果 2008—2012年间成都市居民对社区卫生服务的方便程度、排队时间、就医环境、服务态度、尊重程度、设备设施、解释交流、服务价格、药品价格、隐私保护10个条目的满意度水平均呈随时间线性增长的趋势(P<0.05);对于过度医疗条目,居民的满意度始终维持在极高水平(平均97.6%)。多重线性回归分析结果显示,调查年份、候诊时间及医疗保险类型3个因素对社区卫生服务居民满意度得分的影响有统计学意义(P<0.05)。结论成都市社区卫生服务居民满意率呈逐年上升趋势,但仍存在相对薄弱环节。建议进一步加强社区卫生基本设施建设,坚持基本药物制度,优化就医流程,扩大基本医疗保险的覆盖范围,以促进成都市社区卫生服务的可持续发展。

Objective To study the variation of the residentsˊ satisfaction and the main influencing factors about the community health service（CHS）in Chengdu from 2008 to 2012. Methods Objective sampling method was adopted between March and April each year from 2008-2012. Using interception investigation,some community residents at the gate of the com-munity health service institutions located in the 6 downtown districts were stopped to fill in the satisfaction questionnaire included in the project ＆quot; Major City Community Health Service System Construction＆quot; and interviewed by structural formula interview meth-od about demographic characteristics,utilization of CHS,and satisfaction of CHS. The number of investigated residents was 600 in 2008,503 in 2009,604 in 2010,602 in 2011 and 601 in 2012 and totally 2 910 in the five consecutive years. Results It was a linear development between time and the satisfying degree of ten items including convenience,queuing time,hospital envi-ronment,service attitude,respect level,facilities,eXplanation and communication,service price,drug price and privacy pro-tection（P〈0. 05）. Residents satisfaction rate with the item of overtreatment remained very high（97. 6% on average）. Multi-ple linear regression analysis revealed that investigating years,the waiting time,medical insurance types were the main influen-cing factors and it was significant（ P〈0. 05）. Conclusion There is an upward trend in resident satisfaction with CHS in Chengdu,but weak links still eXists in some degree. It is needed to strengthen the construction of CHS basic facilities,continu-ously carry out national essential drugs policy,enlarge the coverage of basic medical insurance so as to promote the sustainable development of CHS in Chengdu.