基于社区首诊视角的老年人公共卫生服务利用情况分析

Analysis of the Public Health Service Utilization in the Elderly in View of First 1 Treatment in the Community

目的了解厦门市老年人利用社区首诊服务的意愿及其影响因素,为制定基本公共卫生服务政策提供参考依据。方法随机抽取开元和祥平两个社区的829名60岁及以上老年人进行入户访谈式调查,通过多因素Logistic逐步回归分析影响因素。结果老年人自愿选择社区卫生服务中心首诊的比例为46.1%;较常获得社区卫生服务中心提供的健康教育服务的占15.5%;签约了家庭医生服务的占8.7%;过去1年内接受社区免费体检的占57.4%;接受过社区医生对其进行生活方式评估或老年保健指导的占45.9%。年龄越高、家庭月收入越低、有签约家庭医生、获得免费体检、没有患有慢性病的老年人,自愿社区首诊的比例越高(P<0.05)。结论政府应保证基本公共卫生服务的落实,提升老年人对社区医疗服务的信心,有效利用社区卫生资源。

Objective To understand willingness to select community doctor as first treatment of the elderly and its influencing factor for providing reference basis for the basic public health services policy. Methods A total of 829 residents aged 60 years and older from the Kaiyuan and Xiangping Communities were interviewed and influencing factors were analyzed by using multivariate Logistic regression. Results The proportion of the elderly who had the willingness to select first treatment in the community was 46.1%; 15.5% of the elderly often got the health education from community health services; 8.7% of the elderly singed general practitioner(GP); 57.4% of the elderly received free physical examination by community health services in the past year; 45.9% the elderly got lifestyle evaluation or health guidance by the community doctor. The age, family income, signing GP, received community free physical examination, suffering from chronic disease all influenced the willingness to select community doctor as first treatment(P<0.05). Conclusion The government should ensure the implementation of basic public health services and improve the faith of the elderly using community medical services, so as to make an efficient use of health resources.