Chinese General Practice ›› 2022, Vol. 25 ›› Issue (34): 4312-4317.DOI: 10.12114/j.issn.1007-9572.2022.0519
• Original Research·Focus on Primary Health Services • Previous Articles Next Articles
Received:
2022-07-21
Revised:
2022-09-13
Published:
2022-12-05
Online:
2022-09-29
Contact:
YU Qianqian
About author:
通讯作者:
于倩倩
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0519
条目 | 平均得分( | 最低得分 | 最高得分 |
---|---|---|---|
D1每次来签约机构看病时,是您的家庭医生负责吗 | 3.37±0.81 | 1 | 4 |
D2您的家庭医生理解您咨询的问题吗 | 3.62±0.61 | 1 | 4 |
D3您的家庭医生给您的解释容易理解吗 | 3.61±0.61 | 1 | 4 |
D4您有健康问题会和家庭医生(团队成员)进行交流吗 | 3.57±0.63 | 1 | 4 |
D5您的家庭医生是否耐心听您叙述病情 | 3.64±0.59 | 1 | 4 |
D6您在和家庭医生(团队成员)交谈问题时,会感到轻松吗 | 3.57±0.63 | 1 | 4 |
D7您的家庭医生不仅了解您的病情,还了解您的其他情况吗 | 3.33±0.84 | 1 | 4 |
D8您的家庭医生知道您和谁住在一起吗 | 3.31±0.87 | 1 | 4 |
D9您的家庭医生知道您最重要的健康问题吗 | 3.50±0.69 | 1 | 4 |
D10您的家庭医生知道您完整的患病情况吗 | 3.34±0.75 | 1 | 4 |
D11您的家庭医生了解您的工作或就业情况吗 | 3.22±0.83 | 1 | 4 |
D12您的家庭医生在开价格较高的药品时,会征求您的意见吗 | 3.19±0.82 | 1 | 4 |
D13您的家庭医生了解您正在服用的所有药物吗 | 3.45±0.70 | 1 | 4 |
D14您是否愿意换一个家庭医生 | 3.04±0.90 | 1 | 4 |
D15如果很容易给您换一个家庭医生,您是否愿意 | 2.98±0.92 | 1 | 4 |
Table 1 PCAT continuity dimension scores for 1 098 contracted residents
条目 | 平均得分( | 最低得分 | 最高得分 |
---|---|---|---|
D1每次来签约机构看病时,是您的家庭医生负责吗 | 3.37±0.81 | 1 | 4 |
D2您的家庭医生理解您咨询的问题吗 | 3.62±0.61 | 1 | 4 |
D3您的家庭医生给您的解释容易理解吗 | 3.61±0.61 | 1 | 4 |
D4您有健康问题会和家庭医生(团队成员)进行交流吗 | 3.57±0.63 | 1 | 4 |
D5您的家庭医生是否耐心听您叙述病情 | 3.64±0.59 | 1 | 4 |
D6您在和家庭医生(团队成员)交谈问题时,会感到轻松吗 | 3.57±0.63 | 1 | 4 |
D7您的家庭医生不仅了解您的病情,还了解您的其他情况吗 | 3.33±0.84 | 1 | 4 |
D8您的家庭医生知道您和谁住在一起吗 | 3.31±0.87 | 1 | 4 |
D9您的家庭医生知道您最重要的健康问题吗 | 3.50±0.69 | 1 | 4 |
D10您的家庭医生知道您完整的患病情况吗 | 3.34±0.75 | 1 | 4 |
D11您的家庭医生了解您的工作或就业情况吗 | 3.22±0.83 | 1 | 4 |
D12您的家庭医生在开价格较高的药品时,会征求您的意见吗 | 3.19±0.82 | 1 | 4 |
D13您的家庭医生了解您正在服用的所有药物吗 | 3.45±0.70 | 1 | 4 |
D14您是否愿意换一个家庭医生 | 3.04±0.90 | 1 | 4 |
D15如果很容易给您换一个家庭医生,您是否愿意 | 2.98±0.92 | 1 | 4 |
项目 | 例数 | 得分 | t(F)值 | P值 | |
---|---|---|---|---|---|
签约机构 | 68.888 | <0.001 | |||
乡镇卫生院 | 557 | 3.51±0.41 | |||
社区卫生服务机构 | 541 | 3.26±0.58 | |||
性别 | 0.800 | 0.371 | |||
男 | 445 | 3.37±0.51 | |||
女 | 653 | 3.39±0.51 | |||
年龄(岁) | 3.519a | <0.001 | |||
<18 | 11 | 3.12±0.67 | |||
18~29 | 136 | 2.93±0.59 | |||
30~39 | 61 | 3.31±0.55 | |||
40~49 | 156 | 3.29±0.52 | |||
50~59 | 205 | 3.46±0.46 | |||
≥60 | 529 | 3.51±0.43 | |||
受教育程度 | 42.925a | <0.001 | |||
小学及以下 | 641 | 3.49±0.44 | |||
初中 | 233 | 3.38±0.50 | |||
高中/中专 | 77 | 3.30±0.51 | |||
大专 | 54 | 3.13±0.61 | |||
本科及以上 | 93 | 2.84±0.58 | |||
婚姻状况 | 52.538a | <0.001 | |||
未婚 | 141 | 2.91±0.60 | |||
已婚 | 832 | 3.45±0.46 | |||
离异 | 5 | 3.11±0.25 | |||
丧偶 | 120 | 3.47±0.45 | |||
职业 | 22.251a | <0.001 | |||
在职人员 | 649 | 3.47±0.47 | |||
在校学生 | 106 | 2.88±0.59 | |||
离退休人员 | 37 | 3.19±0.53 | |||
无固定职业 | 306 | 3.39±0.47 | |||
个人月收入(元) | 3.070a | 0.070 | |||
<2 000 | 770 | 3.42±0.51 | |||
2 000~2 999 | 112 | 3.33±0.52 | |||
3 000~3 999 | 82 | 3.27±0.52 | |||
4 000~4 999 | 51 | 3.35±0.50 | |||
≥5 000 | 83 | 3.22±0.54 | |||
自评健康状况 | 1.230a | 0.296 | |||
非常好 | 219 | 3.40±0.52 | |||
比较好 | 440 | 3.36±0.51 | |||
一般 | 297 | 3.42±0.54 | |||
比较差 | 132 | 3.38±0.45 | |||
非常差 | 10 | 3.13±0.62 | |||
是否确诊慢性病 | 27.889 | <0.001 | |||
是 | 503 | 3.47±0.45 | |||
否 | 595 | 3.31±0.55 |
Table 2 Comparison of PCAT continuity dimension scores of contracted residents with different characteristics
项目 | 例数 | 得分 | t(F)值 | P值 | |
---|---|---|---|---|---|
签约机构 | 68.888 | <0.001 | |||
乡镇卫生院 | 557 | 3.51±0.41 | |||
社区卫生服务机构 | 541 | 3.26±0.58 | |||
性别 | 0.800 | 0.371 | |||
男 | 445 | 3.37±0.51 | |||
女 | 653 | 3.39±0.51 | |||
年龄(岁) | 3.519a | <0.001 | |||
<18 | 11 | 3.12±0.67 | |||
18~29 | 136 | 2.93±0.59 | |||
30~39 | 61 | 3.31±0.55 | |||
40~49 | 156 | 3.29±0.52 | |||
50~59 | 205 | 3.46±0.46 | |||
≥60 | 529 | 3.51±0.43 | |||
受教育程度 | 42.925a | <0.001 | |||
小学及以下 | 641 | 3.49±0.44 | |||
初中 | 233 | 3.38±0.50 | |||
高中/中专 | 77 | 3.30±0.51 | |||
大专 | 54 | 3.13±0.61 | |||
本科及以上 | 93 | 2.84±0.58 | |||
婚姻状况 | 52.538a | <0.001 | |||
未婚 | 141 | 2.91±0.60 | |||
已婚 | 832 | 3.45±0.46 | |||
离异 | 5 | 3.11±0.25 | |||
丧偶 | 120 | 3.47±0.45 | |||
职业 | 22.251a | <0.001 | |||
在职人员 | 649 | 3.47±0.47 | |||
在校学生 | 106 | 2.88±0.59 | |||
离退休人员 | 37 | 3.19±0.53 | |||
无固定职业 | 306 | 3.39±0.47 | |||
个人月收入(元) | 3.070a | 0.070 | |||
<2 000 | 770 | 3.42±0.51 | |||
2 000~2 999 | 112 | 3.33±0.52 | |||
3 000~3 999 | 82 | 3.27±0.52 | |||
4 000~4 999 | 51 | 3.35±0.50 | |||
≥5 000 | 83 | 3.22±0.54 | |||
自评健康状况 | 1.230a | 0.296 | |||
非常好 | 219 | 3.40±0.52 | |||
比较好 | 440 | 3.36±0.51 | |||
一般 | 297 | 3.42±0.54 | |||
比较差 | 132 | 3.38±0.45 | |||
非常差 | 10 | 3.13±0.62 | |||
是否确诊慢性病 | 27.889 | <0.001 | |||
是 | 503 | 3.47±0.45 | |||
否 | 595 | 3.31±0.55 |
自变量 | b(95%CI) | SE | SB | t值 | P值 | |
---|---|---|---|---|---|---|
签约机构(以乡镇卫生院为参照) | ||||||
社区卫生服务机构 | -0.250(-0.309,-0.191) | 0.030 | -0.243 | -8.300 | <0.001 | |
性别(以男为参照) | ||||||
女 | 0.028(-0.034,0.090) | 0.032 | 0.027 | 0.895 | 0.371 | |
年龄(以原值进入) | 0.009(0.008,0.011) | 0.001 | 0.332 | 11.649 | <0.001 | |
受教育程度(以小学及以下为参照) | ||||||
初中 | -0.112(-0.184,0.040) | 0.037 | -0.089 | -3.059 | 0.002 | |
高中/中专 | -0.193(-0.306,-0.080) | 0.058 | -0.096 | -3.341 | 0.001 | |
大专 | -0.363(-0.496,-0.229) | 0.068 | -0.153 | -5.342 | <0.001 | |
本科及以上 | -0.656(-0.760,-0.551) | 0.053 | -0.355 | -12.331 | <0.001 | |
婚姻状况(以未婚为参照) | ||||||
已婚 | 0.540(0.454,0.626) | 0.044 | 0.450 | 12.320 | <0.001 | |
离异 | 0.195(-0.235,0.625) | 0.219 | 0.026 | 0.890 | 0.374 | |
丧偶 | 0.557(0.440,0.675) | 0.060 | 0.338 | 9.318 | <0.001 | |
职业(以在职人员为参照) | ||||||
在校学生 | -0.587(-0.687,-0.448) | 0.051 | -0.337 | -11.558 | <0.001 | |
离退休人员 | -0.282(-0.443,-0.121) | 0.082 | -0.099 | -3.437 | 0.001 | |
无固定职业 | -0.079(-0.239,0.084) | 0.034 | -0.069 | -2.343 | 0.019 | |
个人月收入(以原值进入) | -0.009(-0.019,2.23×10-4) | 0.005 | -0.047 | -1.935 | 0.053 | |
自评健康状况(以非常好为参照) | ||||||
比较好 | -0.043(-0.126,0.041) | 0.043 | -0.041 | -1.001 | 0.317 | |
一般 | 0.016(-0.074,0.106) | 0.046 | 0.014 | 0.343 | 0.732 | |
比较差 | -0.024(-0.135,0.088) | 0.057 | -0.015 | -0.417 | 0.677 | |
非常差 | -0.268(-0.594,0.059) | 0.166 | -0.049 | -1.609 | 0.108 | |
是否确诊慢性病(以是为参照) | ||||||
否 | -0.163(-0.223,0.102) | 0.031 | -0.158 | -5.281 | <0.001 | |
常量 | 3.515(3.321,3.708) | 0.099 | — | 35.645 | <0.001 |
Table 3 Multiple linear regression analysis of factors influencing PCAT-continuity dimension scores of contracted residents
自变量 | b(95%CI) | SE | SB | t值 | P值 | |
---|---|---|---|---|---|---|
签约机构(以乡镇卫生院为参照) | ||||||
社区卫生服务机构 | -0.250(-0.309,-0.191) | 0.030 | -0.243 | -8.300 | <0.001 | |
性别(以男为参照) | ||||||
女 | 0.028(-0.034,0.090) | 0.032 | 0.027 | 0.895 | 0.371 | |
年龄(以原值进入) | 0.009(0.008,0.011) | 0.001 | 0.332 | 11.649 | <0.001 | |
受教育程度(以小学及以下为参照) | ||||||
初中 | -0.112(-0.184,0.040) | 0.037 | -0.089 | -3.059 | 0.002 | |
高中/中专 | -0.193(-0.306,-0.080) | 0.058 | -0.096 | -3.341 | 0.001 | |
大专 | -0.363(-0.496,-0.229) | 0.068 | -0.153 | -5.342 | <0.001 | |
本科及以上 | -0.656(-0.760,-0.551) | 0.053 | -0.355 | -12.331 | <0.001 | |
婚姻状况(以未婚为参照) | ||||||
已婚 | 0.540(0.454,0.626) | 0.044 | 0.450 | 12.320 | <0.001 | |
离异 | 0.195(-0.235,0.625) | 0.219 | 0.026 | 0.890 | 0.374 | |
丧偶 | 0.557(0.440,0.675) | 0.060 | 0.338 | 9.318 | <0.001 | |
职业(以在职人员为参照) | ||||||
在校学生 | -0.587(-0.687,-0.448) | 0.051 | -0.337 | -11.558 | <0.001 | |
离退休人员 | -0.282(-0.443,-0.121) | 0.082 | -0.099 | -3.437 | 0.001 | |
无固定职业 | -0.079(-0.239,0.084) | 0.034 | -0.069 | -2.343 | 0.019 | |
个人月收入(以原值进入) | -0.009(-0.019,2.23×10-4) | 0.005 | -0.047 | -1.935 | 0.053 | |
自评健康状况(以非常好为参照) | ||||||
比较好 | -0.043(-0.126,0.041) | 0.043 | -0.041 | -1.001 | 0.317 | |
一般 | 0.016(-0.074,0.106) | 0.046 | 0.014 | 0.343 | 0.732 | |
比较差 | -0.024(-0.135,0.088) | 0.057 | -0.015 | -0.417 | 0.677 | |
非常差 | -0.268(-0.594,0.059) | 0.166 | -0.049 | -1.609 | 0.108 | |
是否确诊慢性病(以是为参照) | ||||||
否 | -0.163(-0.223,0.102) | 0.031 | -0.158 | -5.281 | <0.001 | |
常量 | 3.515(3.321,3.708) | 0.099 | — | 35.645 | <0.001 |
[1] |
赵婧革,匡莉,汪雨潭. 全科医疗核心特征功能定义与内涵界定研究:连续性[J]. 中国卫生政策研究,2017,10(5):13-19. DOI:10.3969/j.issn.1674-2982.2017.05.003.
|
[2] |
匡莉,
|
[3] |
丁欣欣,张曦,周梦萍,等. 全科医疗核心特征功能对糖尿病患者自我管理效能影响[J]. 中国社会医学杂志,2022,39(1):76-80. DOI:10.3969/j.issn.1673-5625.2022.01.020.
|
[4] |
国务院医改办,国家卫生计生委,国家发展改革委,等. 关于推进家庭医生签约服务的指导意见[A/OL]. (2016-06-06)[2022-08-13].
|
[5] |
牡丹晚报. 全市"签约家庭医生"超万人[N/OL]. (2019-05-20)[2022-04-22].
|
[6] |
牡丹晚报. 我市60岁以上老年人家庭医生签约服务覆盖率64.7%[N/OL]. (2022-01-12)[2022-04-22].
|
[7] |
|
[8] |
乔静怡,陈王心悦,杨君洁,等. 基于感知质量评价的农村家庭医生签约服务连续性研究[J]. 中国全科医学,2021,24(19):2440-2444. DOI:10.12114/j.issn.1007-9572.2021.00.182.
|
[9] |
李文祯. 社区首诊制可行性研究[D]. 武汉:华中科技大学,2016.
|
[10] |
柳松艺,孟文奇,彭海波,等. 某市家庭医生服务签约居民的就诊体验研究[J]. 中华医院管理杂志,2021,37(9):766-771. DOI:10.3760/cma.j.cn111325-20210325-00265.
|
[11] |
|
[12] |
吴明隆. 结构方程模型:AMOS操作与应用[M]. 重庆:重庆大学出版社,2016:486-490.
|
[13] |
张涛. 患者视角下的全科医师服务连续性测评与影响因素研究[D]. 杭州:杭州师范大学,2018.
|
[14] |
邱宝华,黄蛟灵,梁鸿,等. 家庭医生签约服务利用与满意度的比较研究[J]. 中国卫生政策研究,2016,9(8):31-36.DOI:10.3969/j.issn.1674-2982.2016.08.006.
|
[15] |
山东省卫生与计划生育委员会. 关于做实家庭医生签约服务工作的通知[A/OL]. (2018-05-26)[2022-04-22].
|
[16] |
汤晓. 健康中国背景下家庭医生服务能力建设研究[D]. 上海:上海工程技术大学,2020.
|
[17] |
付英杰,王健,俞乐欣,等. 健康中国背景下家庭医生签约服务发展中的问题与对策研究[J]. 中国全科医学,2019,22(19):2296-2300. DOI:10.12114/j.issn.1007-9572.2019.00.352.
|
[18] |
宁艳阳. 家庭医生:居民身边的医生朋友[J].中国卫生,2021,7(6):13-15.
|
[19] |
张明妍,丁晓燕,高运生. 我国社区卫生服务机构服务能力现状、问题及对策[J]. 中国卫生事业管理,2016,33(9):654-656,681.
|
[20] |
陈意. 分级诊疗模式下患者就医行为与机构选择研究[D]. 安徽:合肥工业大学,2019.
|
[21] |
肖蕾,张太慧,张雅莉,等. 分级诊疗视角下家庭医生签约服务"签而不约"的原因及对策研究[J]. 中国全科医学,2018,21(25):3063-3068. DOI:10.12114/j.issn.1007-9572.2018.25.007
|
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