基于需方视角下的初级卫生保健质量评估及影响因素分析

The quality evaluation of primary health care based on demand-side perspective and influencing factors analysis

目的调查在需方视角下上海市初级卫生保健质量评估现状,分析其存在的质量薄弱环节并进一步探究其影响因素。方法采用问卷调查法,随机抽取上海市6所社区卫生服务中心,选取2020年10月1日—2021年4月15日于此6所社区卫生服务中心就诊的患者或陪同家属作为调查对象,调查内容包括一般人口学特征、初级卫生保健质量评估量表以及卫生服务利用情况。结果上海市的初级卫生保健质量评估结果为首诊利用(2.77)、首诊可及(2.51)、持续性(3.20)、协调性(3.10)、综合性(3.30)、以家庭为中心(3.12)、以社区为导向(3.06),总分(3.01),影响初级卫生保健质量评估的因素包括学历、婚姻状况、户口所在地、一年内就诊次数以及健康档案。结论上海市初级卫生保健质量平均中首诊可及性的评价最低,上海市需要在加强初级卫生保健宣传和普及的同时对自身服务能力、服务质量进行优化升级,以满足居民对初级卫生保健服务更多的需求与更高的要求。

Objective To investigate the current status of quality assessment of primary health care in Shanghai from the demand-side perspective,analyze the weaknesses in quality,and further explore its influencing factors.Methods Using the questionnaire survey method,we randomly selected 6 community health service centers in Shanghai,and selected patients or accompanying family members who visited these 6 community health service centers from October 1,2020 to April 15,2021,as the survey subjects.The survey content including general demographic characteristics,primary health care quality assessment scale,and health service utilization.Results The evaluation results of the quality of primary health care in Shanghai:first visit utilization(2.77),first visit accessible(2.51),continuity(3.20),coordination(3.10),comprehensive(3.30),family-centered(3.12),community-oriented(3.06),total score(3.01),factors that affect the quality of primary health care evaluation include academic qualifications,marital status,registered permanent residenc location,number of visits within a year,and health records.Conclusions Among them,the evaluation of the accessibility of the first visit is the lowest.Shanghai urgently needs to optimize and upgrade its own service capabilities and service quality while strengthening the promotion and popularization of primary health care,so as to meet more demand and higher requirements of residents on primary health care services.