南京市浦口区家庭医生签约状况对社区卫生服务利用的影响

The Effects of Contract Service Status from General Practitioner on the Utilization of Health Services among Community Residents in Pukou District, Nanjing City

目的:探讨家庭医生签约状况对居民社区卫生服务利用的影响。方法:采用普查法和便利抽样法对南京市浦口区签约和非签约居民进行自编问卷调查,采用χ~2检验分析签约与否对卫生服务利用的影响。结果:调查的2302名社区居民中,签约居民1311人(56.95%),未签约居民991人(43.05%)。签约居民社区首诊服务利用率明显高于非签约居民,家庭医生签约服务与转诊经历之间没有关联性(P>0.01)。签约居民知晓家庭医生组在健康评估与规划、健康档案建立、健康教育活动、健康教育材料获取等方面的利用率分别是不知晓组的1.78、2.71、2.33和2.01倍,差异有统计学意义(P<0.01)。结论:家庭医生签约服务在一定程度上促进了分级诊疗实施,应提升签约服务的有效性,提高居民对家庭医生签约服务的利用度。

Objective: To explore the effects of contract service status from general practitioner(GP) on the utilization of health services among community residents. Methods: A self-designed questionnaire was used to conduct surveys of contracted and non-contracted residents in Pukou district in Nanjing by census method and convenience sampling method. The chi-square test was performed to analyze the impact of GP contractual services on the utilization of health services. Results: 2302 community residents were included, of which 1311(56.95%) were contracted residents and 991(43.05%) were non-contracted residents. It was found that the utilization ratio of contractual services of contracted residents was significantly higher than that of non-contracted residents in the community first-visit service, but the contractual services were not associated with referral experience among community residents(P>0.01). The utilization of the contractual services in obtaining health assessment and planning, establishing health records, participating in health education activities and obtaining health education materials was1.78, 2.71, 2.33, and 2.01 times of the awareness group who knew the name of GP(P<0.01), respectively. Conclusion: The GP contractual service is helpful to promote the optimization of hierarchical medical system, but the effectiveness of contracted services should be strengthened, and the residents’ utilization of contracted services should be optimized.