盐城市大丰区农村家庭医生服务签约老年人的续约意愿研究

Study on the Willingness of the Elderly to Renew the Contract for the Rural Family Doctor Service in Dafeng District,Yancheng City

目的:了解盐城市大丰区农村家庭医生签约服务签约老年人的续约意愿,探讨其影响因素,为提高农村老年人签约率,提升农村老年人群的家庭医生签约服务质量提供参考。方法:采用分层整群抽样的方法,抽取盐城大丰区60周岁及以上农村老年人进行问卷调查。对签约老年人的续约意愿进行χ^(2)检验、多因素logistic回归分析。结果:共得到385份有效问卷。盐城市大丰区农村家庭医生服务签约老年人的续约意愿为86.8%(334/385)。单因素分析显示,年龄、性别、婚姻状况、医疗机构的硬件设施、签约后健康状况、对签约服务总体满意度、对签约医生信任度、服务包类型等是老年人续约意愿的影响因素。多因素分析显示,对签约服务总体评价满意(OR=32.158)、认为签约机构硬件设施完善(OR=23.356)、认为能够提供老年卫生服务(OR=3.974)、对签约医生信任(OR=6.575)的签约老年人续约意愿更高。结论:盐城市大丰区农村家庭医生服务签约老年人的续约意愿较高。应通过加强农村基层医疗机构建设、优化签约服务包内容,提高签约老年人对签约服务满意度和对签约医生信任度等措施促进农村老年人群签约服务的可持续发展。

Objective:To understand the willingness of the contracted elderly to renew the contract for rural family doctors in Dafeng district of Yancheng and explore the influencing factors,so as to provide references for improving the contracting rate of the rural elderly and the quality of family doctor contracting services for rural seniors.Methods:A stratified cluster sampling method was used to select rural elderly aged 60 years and over in Dafeng district of Yancheng city for face-to-face questionnaire survey.Chi-square test and multivariate logistic regression analysis were carried out on the contract renewal willingness of the elderly.Results:A total of 385 valid questionnaires were obtained.The willingness of the rural elderly to renew the contract for family doctor service in Dafeng district of Yancheng was 86.8%(334/385).Univariate analysis showed that age,gender,marital status,hardware facilities of medical institutions,health status after contracting,the overall satisfaction of the contracted service,the trust of the contracted doctor and the type of service package were the influencing factors of the willingness of the elderly to renew their contracts.The results of the multivariate analysis showed that the elderly who were satisfied with the overall evaluation of the contracted services(OR=32.158),believed that the contracted institutions had complete hardware facilities(OR=23.356),believed that they could provide health services for the elderly(OR=3.974),and trusted the contracted doctors(OR=6.575)had a higher willingness to renew the contracts.Conclusion:The renewal of contracting services for rural family doctors in Dafeng district of Yancheng is relatively high.It is necessary to promote the sustainable development of rural elderly contracting services through measures such as strengthening the construction of rural grassroots medical institutions,optimizing the content of contracted service packages,increasing the satisfaction of the contracted elderly with contracted services and the trust of contracted doctors.