基于知信行理论的北京市居民社区健康管理服务认知、偏好及利用研究

Study on Cognition,Preference and Utilization of Community Health Management Services in Beijing Based on the Theory of Knowledge,Belief and Practice

目的:分析居民对社区健康管理服务的认知、偏好、利用状况及其影响因素,为相关部门制定政策、促进医防融合提供参考。方法:基于知信行理论自制调查问卷,采用随机抽样方法于2022年1—2月对北京市3个行政区的5个社区共384名居民进行调查。结果:83.8%的居民对社区健康管理服务有不同程度的认知,但比较了解的仅占28.1%;年龄、所在行政区、自评健康状况对居民认知程度的影响差异有统计学意义(χ^(2)值分别为12.944、41.182、13.874,P值均<0.05)。相较社区卫生服务机构,居民更偏好公立医院提供的健康管理服务,年龄、所在行政区、本地居住时长、婚姻状况、学历、个人月收入、是否患慢性病对居民健康管理服务机构偏好的影响差异有统计学意义(χ^(2)值分别为28.224、15.485、18.306、11.261、27.202、18.428、15.870,P值均<0.05)。43.5%的调查对象未利用过社区健康管理服务,年龄、所在行政区、本地居住时长、学历、是否患有慢性病对居民社区健康管理服务利用的影响差异有统计学意义(χ^(2)值分别为18.677、20.877、6.016、10.080、7.524,P值均<0.05)。结论:当前北京市居民对社区健康管理服务的认知和利用水平较低,对社区健康管理服务偏好程度不高,偏好内容不均衡,应从供给侧和需求侧两方面发力,提高居民对社区健康管理服务的认知和利用。

OBJECTIVE To analyze the residents’cognition,preference,utilization and influencing factors to the community health management services.METHODS A questionnaire was designed to investment the residents’cognition,preference and utilization to community health management services based on the theory of knowledge,belief and practice to investigate.A random sampling method was used to carry out a random interception questionnaire survey in five communities from three administrative regions in Beijing.A total of 384 valid questionnaires were collected.RESULTS 83.8%of the residents had different levels of cognition to the community health management services,but only 28.1%had a better understanding;the influence of age,administrative region and self-rated health status on residents’cognitive level was statistically significant(χ^(2)=12.944,41.182,13.874,P<0.05).Compared with community health service institutions,residents prefered health management services provided by public hospitals.There were statistically significant differences in the influence of age,administrative region,length of local residence,marital status,educational background,personal monthly income and whether suffering from chronic diseases on residents’preference for health management service institutions(χ^(2)=28.224,15.485,18.306,11.261,27.202,18.428,15.870,P<0.05).43.5%of the respondents had not used community health management services.There were statistically significant differences in the impact of age,administrative region,local length of residence,educational background and chronic diseases on the utilization of community health management services(χ^(2)=18.677,20.877,6.016,10.080,7.524,P<0.05).CONCLUSION At present,Beijing residents’cognition and utilization of community health management services are still low,their preference for community health management services is not high,and their preference content is uneven.Efforts should be made from the supply side and the demand side to improve residents’cognition and utilization of community health management services.