上海市虹口区家庭医生签约服务需求及影响因素分析

Analysis on the demand status and influencing factors of family doctors contracting services in Hongkou District of Shanghai

目的:分析居民对家庭医生“1+1+1”签约服务的需求状况及需求结构,探索需求差异的影响因素,为提供有吸引力的签约服务提供政策依据。方法:在上海市“1+1+1”签约试点区虹口区欧阳路街道开展问卷调查,采集有效样本1745份;对服务需求指标进行探索性因子分析。结果:居民对签约服务的需求目前主要集中在配药服务上;将20项需求指标合成为3个公因子,个性化服务需求、基本医疗服务需求、健康管理服务需求,其主要影响因素分别包括性别、健康状况、就医行为与满意度,健康行为与满意度,婚姻与综合满意度。结论:药品需求仍然是居民当前最为主要的需求,不同特征的居民存在签约服务的需求差异;有必要针对不同人群提供个性化的、切实需要的签约服务,这样才能维持稳定的签约关系、引导居民下沉就诊、构建有序有效医疗服务体系。

Objective:To analyze the demand status and structure of "1+1+1" contract services for family physicians, to explore the influencing factors of demand differences and to provide a basis for the policy of providing attractive contract services. Methods:An on-site questionnaire survey was conducted in the streets of Ouyang Road, Hongkou District, in the Shanghai "1+1+1" contracted services piloting area, and 1 745 valid questionnaire samples were collected. The exploratory factor analysis was conducted. Results:The residents' demand was mainly distributed in medical prescription services, extracted 20 demand indicators into three common factors of "Personalized Services Demand","Basic healthcare Services Demand", and "Health Management Services Demand". The main influencing factors were gender, health status, doctor-visiting behavior and satisfaction, health behavior and satisfaction, marriage and comprehensive satisfaction, respectively. Conclusions:Medical demand remained the most dominant for residents, and residents with different characteristics presented varied demand for family doctor contracting services. It is necessary to provide personalized and required contractual services for different groups of people in different categories, so as to maintain consistent contractual relationship, to conduct residents to visit CHSCs and to construct an orderly and effective healthcare services system.