深圳市签约居民对家庭医生服务的评价及续签意愿研究

Evaluation of Family Doctor Services and Intention of Renewing the Contract with the Family Doctor among Contracted Residents in Shenzhen

背景近年来深圳市家庭医生签约服务开展已取得一定进展,但“签而不约”“服务不到位”等现象依然存在。居民作为服务的需求方,研究其对家庭医生服务的评价及续签意愿对促进签约服务的有效开展具有重要意义。目的了解深圳市签约居民对家庭医生服务的评价及续签意愿,为推进家庭医生服务提供科学依据。方法于2016年7月—2017年9月,采取多阶段分层随机抽样法,对深圳市宝安区3个社区健康服务中心的1000例签约居民开展基本情况、家庭医生服务利用与评价、家庭医生续签意愿及原因等内容的问卷调查。共发放问卷1000份,获得有效问卷900份,问卷有效回收率为90.0%。结果900例调查对象中,807例(89.7%)签约居民满意家庭医生的服务,家庭医生服务态度平均得分为(92±8)分。820例(91.1%)签约居民表示愿意继续和家庭医生签约,其中729例(88.9%)签约居民愿意续签家庭医生的原因是认为签约家庭医生就诊更方便;80例(8.9%)不愿意续签的居民中,56例(70.0%)选择的原因是认为签约家庭医生没有用。χ2检验结果显示,是否熟悉家庭医生姓名及坐诊时间、家庭医生主动联系次数、家庭医生服务态度、是否认为家庭医生看病比非家庭医生更仔细、是否满意家庭医生工作及对家庭医生的信任度条目选项不同者的续签意愿不同,差异具有统计学意义(P<0.05)。结论深圳市签约居民对医疗卫生服务评价较好,家庭医生服务续签意愿较高,建议加大宣传推广力度,提升家庭医生服务质量,完善家庭医生服务体系,进而促进家庭医生服务的长远发展。

Background In recent years,some progress has been made in the implementation of contracted family doctor services in Shenzhen,but the phenomena such as"some contracted residents make no appointments"and"some contractual services are unsatisfactory"still exist.To study the evaluation of family doctor services and intention of renewing the contract with the family doctor among the residents,the demand side of healthcare services,may greatly promote the effective development of such services.Objective To explore the evaluation of family doctor services and intention of renewing the contract with the family doctor among contracted residents in Shenzhen,providing scientific evidence for facilitating the development of such services.Methods This survey was conducted in a stratified multistage random sample of 1000 contracted residents from three community health centers of Shenzhen's Baoan District during July 2016 to September 2017.A self-designed questionnaire was used in the survey,which consists of general personal characteristics,use and evaluation of family doctor services,and intention and reasons of renewing the contract.Altogether,900 of them returned responsive questionnaires,obtaining a response rate of 90.0%.Results Among the 900 respondents,807(89.7%)were satisfied with family doctor services.Family doctors'attitude toward residents during delivering services was evaluated as(92±8)points on average.820(91.1%)of the respondents were willing to renew the contract with a family doctor because they thought they could obtain healthcare more conveniently.Among the 80 cases who were not willing to renew the contract,56(70.0%)thought the contractual services were ineffective.Chi-square analysis showed that the intention of renewing the contract differed significantly by the level of familiarity with the family doctor's name and consultation time,number of the family doctor taking the initiative to contact the patient,level of satisfaction with the attitude of the family doctor during delivering healthcare services,whether the family doctor is more careful than other types of doctors during delivering healthcare services,level of satisfaction with family doctor services,and level of trust in the family doctor(P<0.05).Conclusion Family doctor services obtained high appraisals from the contracted residents of Shenzhen.And most of these residents intended to renew the contract.To promote the sustainable development of family doctor services,it is suggested to strengthen the publicity and promotion of such services,increase the level of quality of such services,and improve the family doctor system.