海南省试点市/县居民家庭医生服务签约现状研究

Current Situation of Signing a Contract with Family Doctors in Pilot Cities and Counties in Hainan Province

目的了解海南省试点市/县居民家庭医生服务签约现状。方法采用方便抽样法,以海南省所有已试行家庭医生签约服务的市/县——海口市(龙华区、秀英区、美兰区、琼山区)、琼海市、昌江县、陵水县的20个社区为调查地区,在各社区选取25例15周岁及以上、识字、能够进行良好沟通的居民为研究对象,共500例。于2016年9—12月,采用自行设计的调查问卷进行调查。问卷主要内容有:居民基本情况、居民对家庭医生签约服务的知晓情况和支持情况、居民签约情况、签约时使居民产生顾虑的因素及选择家庭医生时主要考虑的因素。共发放问卷500份,回收有效问卷495份,问卷的有效回收率为99.0%。结果居民对家庭医生签约服务的知晓率为49.3%(244/495);居民对家庭医生签约服务的支持率为88.3%(437/495);居民的家庭医生服务签约率为25.3%(125/495)。不同性别、年龄、工作状况、婚姻状况、参加医疗保险类型、知晓情况、支持情况居民的签约率比较,差异有统计学意义(P<0.05);不同文化程度、家庭年收入、总体健康状况居民的签约率比较,差异无统计学意义(P>0.05)。关于签约时使居民产生顾虑的因素,228例(46.1%)居民选择"不清楚能够获得哪些好处";关于选择家庭医生时主要考虑的因素,315例(63.6%)居民选择"服务水平",249例(50.3%)居民选择"服务态度"。结论居民对家庭医生签约服务的知晓率和签约率不高,性别、年龄、工作状况、婚姻状况、参加医疗保险类型、知晓情况、支持情况可能为影响居民家庭医生签约率的因素。

Objective To observe the current situation of signing a contract with family doctors in pilot cities and counties in Hainan Province. Methods Using convenience sampling,500 literate residents who were 15 years old and above and able to communicate well were selected averagely from 20 communities in pilot cities and counties in Longhua District,Xiuying District,Meilan District and Qiongshan District of Haikou City; Qionghai City,Changjiang County and Lingshui County. A self-designed questionnaire was distributed from September to December in 2016. The main contents of the questionnaire were basic information of residents,the situation of residents＇ awareness and support of signing a contract with family doctors,the current situation of signing a contract with family doctors,factors that made residents worry when signing the contract and factors that residents considered most when choosing family doctors. A total of 500 questionnaires were distributed and 495 valid questionnaires were collected. The effective recovery rate was 99. 0%. Results Residents＇ awareness rate of signing a contract with family doctors was 49. 3%（ 244/495）; the support rate was 88. 3%（ 437/495）; the signing rate was 25. 3%（ 125/495）. There were statistically significant differences in signing rates among residents with different gender,age,work status,marital status,type of medical insurance,awareness rates and support rates（ P 0. 05）. There was no significant difference in signing rates among residents with different educational level,household income and general health status（ P 0. 05）. When it came to factors that made residents worry when signing the contract,228（ 46. 1%） residents did not know what benefits they would get from the family doctor service. As for factors that residents considered most when choosing family doctors,315（ 63. 6%）residents signed the contract for the quality of the service,while 249（ 50. 3%） residents signed the contract because of the service attitude. Conclusion Awareness rates and signing rates of family doctor services are low among residents in pilot cities and counties in Hainan Province. And gender,age,work status,marital status,type of medical insurance,awareness rate and supporting rate may be the factors that influence the signing rate.