中青年楼宇人群社区卫生服务利用满意度分析

Satisfaction analysis of community health service utilization among young and middle-aged building crowds

目的探讨上海社区卫生服务进楼宇的服务利用、在职职工满意度的情况及影响因素。方法采用典型抽样方式对上海北外滩区域的楼宇职工进行问卷调查,共发放问卷1040份,回收有效问卷993份,有效回收率为95.5%。结果楼宇人群对社区卫生服务的总体满意度分值为7.24分,其中对社区卫生服务的服务态度、就医环境、合理收费、有效沟通、合理检查、合理配药、服务效率、有效治疗等方面的评价较高,前3项评分分别为7.90、7.89、7.88分;对长处方、转诊服务、家庭病床、延伸处方、医护人员素质等方面的满意度较低,前3项评分分别为7.38、7.43、7.43分。婚姻状况、户籍性质、自评健康状况以及对家庭医生的认知为社区卫生服务满意度的主要影响因素。其中,上海户籍满意度评分(7.54分)显著高于非上海户籍(6.27分),对家庭医生认知比较清楚的满意度打分为8.33分,显著高于非常不清楚(5.60分)、比较不清楚(6.51分)与一般认知状况人群(7.44分)。结论通过家庭医生将社区卫生服务引入楼宇的政策获得楼宇职工的认可。应加大宣传力度提高对家庭医生制度的认知水平;应通过教育与培训,加强人才队伍的建设,提高社区医务人员的技术水平;政府应及时修改和完善处方政策和三级转诊制度,提高家庭病床的服务质量。

Objective To explore the service utilization of Shanghai community health services and the satisfaction of incumbent workers and the influencing factors.Methods Questionnaire survey was conducted on the building employees in Beiwaitan Street of Shanghai with a typical sampling method.A total of 1040 questionnaires were distributed,and 993 valid questionnaires were recovered.The effective recovery rate was 95.5%.Results The overall satisfaction score of building crowds for community health service was 7.24,with a higher evaluation of the community health service attitude,medical environment,medical expenses,effective communication,reasonable inspection,reasonable dispensing,service efficiency,effective treatment,etc,the first three of which scoring 7.90,7.89,and 7.88.The satisfaction on long prescriptions,referral services,family beds,extended prescriptions,quality of medical staff and other aspects were lower,the first three of which scoring 7.38,7.43 and 7.43.Marital status,household registration,self-rated health status,and cognition of family doctor were the main influencing factors of community health service satisfaction.The satisfaction score of Shanghai household members(7.54)was significantly higher than that of non-Shanghai household members(6.27),and the satisfaction score for the very clear cognition of family doctor was 8.33,which was significantly higher than the very unclear(5.60),relatively unclear(6.51)and general cognitive status groups(7.44).Conclusion The policy of introducing community health service into buildings through family doctor has been recognized by building staff.Publicity efforts should be strengthened to raise the level of awareness of family doctor system;education and training should be used to strengthen the building of talent teams and improve the technical level of community medical staff;the government should promptly modify the prescription policy and the three-level referral system,and to improve the quality of services for home beds.