中老年人家庭医生签约意愿调查及影响因素分析

Study on middle-aged and elderly people′willingness for family doctor contracting and its influencing factors

目的调查中老年人家庭医生签约意愿现状并分析影响因素,为促进重点人群签约家庭医生服务提供对策建议。方法采用分层随机抽样方法,抽取徐州市6个城区的年龄≥45岁的中老年人进行问卷调查,调查其患病及就诊情况和家庭医生签约意愿情况。对数据进行描述性统计分析、单因素分析(χ2检验)和多因素logistic回归分析。结果共收回有效问卷927份,其中272人(29.34%)对家庭医生服务有签约意愿,655人(70.66%)无签约意愿。多因素logistic回归分析结果显示,影响中老年人签约家庭医生的因素有年龄、职业、健康自评状况、两周内就诊情况、患慢性病情况、有无转诊经历以及对家庭医生签约制度的了解程度等。结论中老年人家庭医生签约意愿不高,今后可重点加强年龄较低、务农、健康状况较好的中老年人群家庭医生签约服务的宣传力度,提高其对该服务的知晓度,并积极响应国家双向转诊政策,促进双向转诊和家庭医生签约服务的协同推进,循序渐进实现家庭医生制度的全面推广。

Objective To investigate the middle-aged and elderly people′willingness for family doctor service contracts and its influencing factors,and to provide feasible suggestions for the implementation and promotion of family doctor services.Methods Stratified random sampling method was adopted to select middle-aged and elderly people aged 45 in 6 urban areas of Xuzhou city for questionnaire survey to investigate their illness,medical treatment and their willingness to contract a family doctor.The data acquired were analyzed with statistical description,univariate analysis(χ2 test),and multivariate logistic regression analysis.Results Among the 927 valid questionnaires were recovered,272(29.34%)of them intended to contract a family doctor,and 655(70.66%)had no such intention.Results of multivariate logistic regression showed that the influencing factors of the middle-aged and elderly people′willingness of contracting family doctors were age,occupation,self-rated health,treatment status within two weeks,chronic diseases,referral experience and their knowledge of family physician contract system.Conclusions Middle-aged and elderly people at large are not willing to sign up for family doctors.It is recommended to focus the publicity efforts on those who are relatively younger age,farming and healthier,enhancing their awareness of the service,and encouraging them to support the dual-referral policy.These efforts are expected to promote the coordinated progress of both dual referral and family doctor contract service,hence achieving the national coverage of the family doctor system.