农村居民对家庭医生"签约首诊"忠诚度的影响因素分析
Analysis on the factors influencing the loyalty of rural residents to family doctors'"contract first consultation"
盛清 1蔡利强 2王朝昕3
作者信息
- 1. 上海市闵行区江川社区卫生服务中心全科,上海 200240
- 2. 上海市浦东新区大团社区卫生服务中心全科,上海 201311
- 3. 海南医科大学管理学院,海南海口 570100
- 折叠
摘要
目的 运用服务营销中"顾客忠诚度"的理论,将"签约首诊服务"作为"重要产品",调查和分析农村居民对家庭医生签约首诊服务忠诚度的影响因素,提高家庭医生签约服务的利用率.方法 采用随机抽样方法,选取上海市浦东新区6家农村社区的1 000名居民为调查对象.于2021年5-9月,使用改良美国顾客满意度指数(ASCI)模型和SERVQUAL服务质量评价量表,运用半结构访谈法自行设计签约居民对家庭医生签约首诊服务忠诚度的问卷调查表.收集调查问卷分析差异和影响家庭医生签约首诊服务忠诚度的因素.结果 家庭医生签约首诊服务忠诚度的8个维度期望值和实际值间差异均有统计学意义.家庭医生签约服务忠诚度的58个条目中期望值和实际值的均值差值在1.0以上的共6个,58个条目期望值与实际值差异均有统计学意义.回归模型发现各个维度的期望值均显著提高了签约居民的满意度,期望值比实际值更能影响满意度.结论 浦东新区农村社区卫生服务中心在硬件设施、家庭医生服务态度、医患沟通等方面,签约居民认可程度比较高,在药品供给和医疗辅助技术方面存在短板.建议适度增加社区卫生服务中心自主管理权限,完善和综合医院"上下对接"药品使用制度,探索"全科+专科"综合性的人才培养模式,提高家庭医生签约服务的积极性和主动性.
Abstract
Objective Using the theory of"customer loyalty"in service marketing,taking"contracted first visit serv-ice"as an"important product",investigate and analyze the influencing factors of rural residents'loyalty to family doctor contracted first visit service,and improve the utilization rate of family doctor contracted service.Methods A random sampling method was employed to select 1 000 residents from six rural communities in the Pudong New Area of Shanghai as the subjects of the survey subjects.From May to September 2021,an enhanced American customer satisfaction index(ASCI)model and the SERVQUAL service quality evaluation scale were employed to develop a questionnaire survey on the loyalty of contracted residents to the initial visit service of family doctors using semi-structured interview approach.The survey questionnaires were collated for analysis of the discrepancies and factors influencing the loyalty of family doc-tors to register for initial visit services.Results A statistically significant discrepancy exists between the anticipated and observed values of the 8 dimensions that affect influence the loyalty of family doctors to the initial consultation service.A total of 58 items were identified as influencing the loyalty of family doctors to contract services.Of these,6 items exhibi-ted a mean difference of 1.0 or more between their expected and actual values.Furthermore,the differences between the expected and actual values were statistically significant for all 58 items.The regression model revealed that the anticipated values for each dimension had a notable influence on the satisfaction of contracted residents.Furthermore,the anticipated values exerted a more pronounced effect on satisfaction than the actual values.Conclusion The Pudong New Area Rural Community Health Service Center is perceived to have a relatively high level of recognition among contracted residents in terms of the availability of hardware facilities,the quality of family doctor services,and the communication between doc-tors and patients.Nevertheless,deficiencies exist in the provision of pharmaceuticals and medical technology.It is rec-ommended that the self-management authority of community health service centers be moderately increased,that the drug use system with general hospitals be improved with a view to enhancing its"top-down coordination",that a comprehen-sive talent training model of"general practice+specialty"be explored,and that the enthusiasm and initiative of family doctors to sign contracts for services be enhanced.
关键词
农村社区/签约首诊/忠诚度/影响因素/策略研究Key words
Rural communities/Sign the contract for the first visit/Loyalty/Influencing factors/Operational research引用本文复制引用
出版年
2024
NETL
NSTL
万方数据