广州市慢性病患者社区卫生服务利用现状及影响因素分析

Analysis on the status and influencing factors of community health service utilization for patients with chronic diseases in Guangzhou

[目的]分析当前广州市中老年慢性病患者的社区卫生服务利用现状及影响因素,旨在为提高慢性病患者的社区卫生服务利用率提供依据。[方法]在广州市越秀区、荔湾区、海珠区和天河区随机抽取12家社区,以Anderson医疗卫生服务利用行为模型为理论框架设计问卷,在每家社区选取前来寻求服务的60-70名慢性病患者进行问卷调查,使用SPSS 21. 0对调查结果进行统计分析。[结果] 91. 39%的患者曾接受社区医院的常见病/慢性病诊疗服务,且38. 45%的患者在近3个月内到社区就诊4次及以上,79. 63%的患者会定期在社区医院治疗慢性病;接受健康教育程度、患常见病时是否愿意去社区就诊、是否签约家庭医生和是否在社区确诊慢性病对慢性病患者是否定期在社区治疗慢性病有影响。[结论]中老年慢性病患者社区卫生服务利用率较高,社区卫生服务对其慢性病防控有一定作用,加强中老年慢性病患者健康教育、推进社区慢性病筛查、推进家庭医生签约服务有利于提高社区卫生服务利用率。

Objective To analyze the status and influencing factors of community health service utilization for quinquagenarian patients with chronic diseases in Guangzhou so as to provide basis for improving the utilization rate of community health service for patients with chronic diseases.Methods 12 communities were randomly selected from four districts of Yuexiu,Liwan,Haizhu and Tianhe in Guangzhou. It took Anderson’ s health services utilization behavior model as the theoretical framework to design questionnaire,selected quinquagenarian patients with chronic diseases who came to seek service in each community to conduct questionnaire survey,and conducted statistic analysis of investigation results by SPSS 21. 0. Results 91. 39% of the patients had received the diagnosis and treatment of common/chronic diseases in community hospitals,38. 45% of the patients visited the community four times or more in the past three months,and 79. 63% of the patients would treated chronic diseases in community hospitals on a regular basis. The level of health education,willingness to visit the community when suffered from common diseases,whether to sign family doctor and whether to diagnose chronic diseases in the community had the impact on whether people with chronic diseases treat chronic diseases regularly in the community. Conclusions The utilization rate of community health service for quinquagenarian patients with chronic diseases is high,and community health service plays a certain role in the prevention and control of chronic diseases.Strengthen health education for quinquagenarian patients with chronic diseases,promote the screening of chronic diseases in the community,and promote the signing of services by family doctors are conducive to improving the utilization rate of community health services.