居民社会资本对基本公共卫生服务利用的影响研究

Researches on the Influence of Residents'Social Capital on the Utilization of Basic Public Health Services

目的:了解居民社会资本与其基本公共卫生服务利用的关联,从社会学、管理学交叉视角探求提升基本公共卫生服务利用效率的新路径。方法:以Onyx和Bullen的社会资本量表为基础,于2021年3至6月对南京市某社区居民进行综合问卷调查,使用Mann-Whitney U、Kruskal-Wallis H检验以及logistic回归分析社会资本各维度得分与基本公共卫生服务的二元关联以及社会资本各维度得分对基本公共卫生服务利用的总效应。结果:签约家庭医生、建立健康档案、健康教育、生活方式指导、突发公共卫生事件在社会资本全8个维度差异显著;政府公益热线知晓和利用在6个维度(社区参与、主动性、邻里关系、家人和朋友联系、多样性容忍度及其他)差异显著;接种疫苗在5个维度(社区参与、主动性、邻里关系、家人和朋友联系及其他维度)差异显著。结论:主动性、信任与安全感以及多样性容忍度正向促进家庭医生签约;邻里关系正向促进健康档案建档率和流感疫苗接种率;社区参与正向促进健康教育参与度和突发公共卫生事件接受度;社区参与和主动性正向促进生活方式指导接受频率。

Objective To understand the relationship between residents'social capital and the utilization of basic public health services,and explore a new way to improve the utilization efficiency of basic public health services from the perspectives of sociology and management.Methods Based on Onyx and Bullen's social capital scale,a comprehensive questionnaire survey was conducted on community residents in Nanjing from March to June 2021.Mann-whitney U,Kruskal-Wallis H test and Logistic regression were used to analyze the binary association between the scores of social capital dimensions and basic public health services and the total effect of scores of social capital dimensions on utilization of basic public health services.Results There were significant differences in all the 8 dimensions of social capital,including signing family doctors,establishing health records,health education,lifestyle guidance and public health emergencies.There were significant differences in awareness and utilization of government welfare hotline in six dimensions(community participation,initiative,neighborhood relationship,family and friend connection,tolerance of diversity,and others).Vaccination differed significantly across the five dimensions of community involvement,initiative,neighborhood,family and friend connections and others.Conclusion Initiative,trust,sense of security and tolerance of diversity positively promote the family doctors’signing contracts.Neighbourhood positively promotes health record keeping rates and flu vaccination rates.Community participation positively promotes the participation in health education and acceptance of public health emergencies.Community involvement and initiative positively promote the frequency of lifestyle guidance.