关键词: 慢性病, 社区首诊, 就诊情况

Abstract: Objective　 To investigate the chronic disease consultation status in community healthcare settings in urban and inner suburban areas of Beijing's Chaoyang District，and put forward solutions for the existing problems，promoting the development of seeking healthcare in a hierarchical manner.Methods　In June 2016，we conducted a survey among chronic disease patients from 4 community health centers（CHCs） from 2 medical consortiums in Beijing's Chaoyang District（2 were selected from a medical consortium mainly consisting of CHCs in urban areas，and other 2 from a medical consortium mainly consisting of CHCs in inner suburban areas） with a self-developed questionnaire for obtaining the data concerning consultation in CHCs.320 of the 341 returned responsive questionnaires，achieving a response rate of 93.8%.Results　The educational attainment，annual household income per capita，type of medical insurance，occupation differed significantly between chronic disease patients from urban CHCs and those from inner suburban CHCs（P<0.05）．Moreover，these two groups had significant differences in seeking medical care in CHCs first and supporting initial consultation in CHCs（P<0.05）．However，the level of satisfaction with medical care in CHCs was similar in both groups（P>0.05）．The priority of the top 5 reasons for seeking medical care in CHCs ordered by the two groups was similar，which are short distance between home and the community health center，followed by not too many visits，short waiting time for consultation，good service attitude，and easy access to the prescribed medicines.Both groups demonstrated similar percentage of patients seeking medical care in CHCs for short distance between home and the community health center，not too many visits，short waiting time for consultation，or good service attitude（P>0.05）．Higher percentage of inner suburban patients sought medical care in CHCs for easy access to the prescribed medicines or inexpensive medical expense compared with urban patients（P<0.05）．Conclusion　The consultation status in CHCs differed significantly between these two groups due to medical cost，habit and convenience of medical care seeking.Urban chronic disease patients were less likely to seek medical care in CHCs.

Key words: Chronic disease, Community first contact care, Consultation status