城市社区居民家庭医生签约服务内容的需求调查——以乌鲁木齐市某区居民为例

Demand Investigation of the Contents of Contracted Services for Family Doctors in Urban Communities:A Case Study of Residents in a District of Urumqi City

目的了解乌鲁木齐市城市社区居民对家庭医生签约服务内容的需求情况,为做实做细家庭医生签约服务提供对策建议。方法于2019年5月,采用多阶段、随机抽样法抽取乌鲁木齐某区居民600例,采用自行设计的调查问卷进行调查,用多重线性回归分析探讨其影响因素。结果城市社区居民签约服务需求内容排在前三位的分别是0~6岁儿童/孕妇/老年人健康管理,预防接种服务及社区现场急救;不同性别、年龄、文化程度、婚姻状况、月收入、职业、医疗保险类型及有无慢性病的社区居民对签约服务内容的需求差异有统计学意义(P<0.05)。多重线性回归分析结果显示,性别、医疗保险类型、年龄、月收入是影响城市社区居民对家庭医生签约服务内容需求的因素(P<0.05),女性居民相比男性的需求明显增加(β=2.091),有职工基本医疗保险居民相比城乡居民医疗保险居民需求增加(β=2.761),不同年龄居民签约服务需求不同,70岁以上居民需求最大(β=11.604),月收入为3000~<5000元(β=6.279)与5000元及以上(β=6.651)的居民对签约服务需求相比月收入低于2000元的居民需求增加。结论乌鲁木齐市城市社区居民对目前已经开展和拟开展的各项服务都有不同程度需求,需求程度最高的三项服务内容为0~6岁儿童/孕妇/老年人健康管理,预防接种服务及社区现场急救。从居民的需求层面出发,建议进一步优化签约服务内容,为居民提供多层次的签约服务内容,提高对重点人群的服务水平,并考虑签约居民的经济承受力,推出有偿化服务包,提高签约服务的吸引力,提升签约居民的获得感。

Objective To understand the needs of residents of urban communities in Urumqi for family doctor contracting services,and to provide countermeasures and suggestions for the implementation of family doctor contracting services.Methods In May 2019,a multi-stage,random sampling method was used to extract 600 cases of residents in a certain area of Urumqi.A self-designed questionnaire was used for surveys,and multiple linear regression analysis was used to explore influencing factors.Results The first three items of contract services required by urban community residents were 0-6 years old child/pregnant mother/elderly health management,vaccination ser-vices and community on-site first aid.Different gender,age,education level,marital status,monthly income,occupation,type of medical insurance,and community residents with or without chronic diseases had significant differen-ces in demand for contracted services(P<0.05).The results of multiple linear regression analysis showed that gender,type of medical insurance,age,and monthly income were factors that affected urban community residents'demand for family doctor contracted services(P<0.05).Female residents had significantly greater needs than male resi-dents(β=2.091),Compared with residents with medical insurance for urban and rural residents,residents with employee basic medical insurance had increased demand(β=2.761).Residents of different ages had different needs for contracted services,with residents over 71 years old having the highest demand(β=11.604).Residents with a monthly income of 3000-<5000 yuan(β=6.279)and more than 5000 yuan(β=6.651)had a higher demand for contracted services than residents with a monthly income of less than 2000 yuan.Conclusion Residents of urban communities in Urumqi have varied degrees of demand for various services that have been and are planned to be implemented.The three services with the highest levels of demand are 0-6 years old children/pregnant women/elderly health management,immunization services and community on-site first aid.Based on the needs of residents,measures need to be taken to further optimize the content of contracted services,provide residents with multiple levels of contracted services,and improve the level of service for key groups.In addition,considering the economic endurance of contracted residents,a paid service package will be launched to increase the attractiveness of contracted services and enhance the sense of acquisition of contracted residents.