北京市居民对社区家庭医生式服务的认知和利用情况调查

Survey on awareness and utilization of community family doctors＇ service on residents in Beijing and influential factors

目的调查北京市居民对家庭医生式服务的知晓和实际利用情况，并分析其影响因素。方法采用多阶段随机抽样方法，选取北京市海淀区、西城区和大兴区的8家社区卫生机构作为抽样单位。发放自编问卷，就3个区居民对家庭医生式服务的利用情况进行调查。对回收问卷进行描述性统计，并分析影响因素。结果共发放问卷3008份，回收有效问卷3008份，问卷回收有效率为100％。84．4％的居民知道家庭医生式服务。92．2％的居民利用过家庭医生式服务，其中慢性病患者、家庭年平均门诊花费处于中等水平、首诊机构在社区卫生服务机构、知晓家庭医生式服务的居民对服务的利用率较高。居民在近1年时间里享受最多的服务是免费体检（87．3％）和随访电话（73．4％），上门服务、健康评估、预防保健、健康教育与咨询、体检、康复等项目的利用率均较低。患病情况、经济收入和对家庭医生式服务的知晓情况对服务利用的影响有统计学意义（P〈0．05）。结论北京市社区居民对家庭医生式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；患病情况、经济收入和对家庭医生式服务的知晓是影响服务利用的主要因素。

Objective To investigate the awareness and utilization of community family doctor services of residents in Beijing and analyze its influential factors. Methods Multistage random sampling was adopted to enroll residents in Beijing from eight community health centers in Haidian District, Xicheng District and Daxing District, to investigate the awareness and utilization of community family doctor services. Customized questionnaires were recovered for descriptive statistics and influential factor analysis. Results All the 3 008 effective questionnaires were recovered. The results found that 92.2~/oo of the residents used community family doctor services. Higher utilization rates of community family doctor services was found among those residents of chronic diseases, those with their family＇ s annual average outpatient expenses in the medium level, those with their first choice of medical visits in the community health centers, and those who are aware of family doctor service. Services of the most frequent use in the recent year were physical examination and follow-up phone call（87.3 % and 73.4 % respectively）; those of lower frequency were door-to-door service, health assessment, preventive health care, physical examination,health education and consulting, and rehabilitation service. Factors of statistical significance on utilization of community health services were health condition, financial condition and awareness of community family doctor service（P〈0. 05）. Conclusions Residents in Beijing have a high awareness and utilization of community family doctor services, yet some items of services are seldom used, Health condition, financial condition and awareness of community family doctor service are major influential factors for utilization of community health services.