深圳市社区居民家庭医生签约现况及影响因素分析

Status of Signing on Family Physician for Residents in Shenzhen and its influencing Factors

目的了解深圳市社区居民对家庭医生知晓、签约现况及影响因素,为提高签约率提供理论借鉴。方法采用自制的调查问卷,随机抽样,对深圳市(福田区、龙岗区、罗湖区、龙华新区和光明新区)共40个社康中心,由统一培训的社康中心卫生人员于2016年1月进行现场调查。结果共调查社区居民2672人,签约率为42.3%(1130人)。被调查的对象中,当身体不适时,68.1%的人首诊医院为社康中心。签约率较高的人群主要集中在60岁以上的居民(69%)、经常生病居民(59.8%)、患慢性病居民(55.4%)、对家庭医生知晓度高的居民(70.5%)、有医保的(44.8%)和就医首诊选择社康中心的居民(44.4%)等。结论深圳市的家庭医生服务起步早,居民对家庭医生知晓度高,签约覆盖面较广,但还要进一步完善。可以从对具有签约吸引的人群入手,逐步引导居民签约;加大对家庭医生签约服务宣传力度,健全相关的政策,提高居民的认知;加强社区卫生服务中心的服务质量,提高居民的满意度等。

Objective To understand the current progress and influencing factors of residents contracts with community family physicians in Shenzhen, provide theoretical reference to further improve signing rate. Methods Self-made questionnaire and random sampling are used and site investigation conducted by community health center personnel in Shenzhen（Futian, Longgang District, Luohu District, Longhua District, and a bright new area） with coverage of 40 community health centers in January of 2016. Results A total of 2672 people was investigated, with signing rate 42.3%. Among all residents been investigated, 68.1% prefer to go to community health center for health services when they are not well. Signing rates are higher among the residents aged above 60（69%）, often ill residents（59.8%）, residents suffering from chronic diseases（55.4%）, and with high awareness degree of family physicians（70.5%）, with insurance（44.8%） and whose first choice of visit is community health center（44.4%） and so on. Conclusion The family doctor service started early in Shenzhen, residents have high awareness of the family doctors and high signing coverage, more progress could be achieved through further expanding coverage of physician doctor contracts, improving propaganda of the service, perfecting relevant policies and enhancing quality of services, and improving residents satisfaction and so on.