首页|我国中部地区流动人口家庭医生签约现状及影响因素分析

我国中部地区流动人口家庭医生签约现状及影响因素分析

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目的 分析我国中部地区流动人口家庭医生签约现状及其影响因素,为更好实现流动人口基本公共卫生服务均等化、改善流动人口家庭医生签约现状提供参考依据.方法 基于2018年全国流动人口卫生计生动态监测调查数据,筛选出流入中部地区且流动时间≥6个月的流动人口,结合SPSS 26.0软件分别建立logistic回归模型和决策树模型分析流动人口签约家庭医生的影响因素.结果 中部地区流动人口样本中家庭医生签约率为19.68%,知晓率为46.88%.Logistic回归结果显示年龄≥45岁(OR=1.305,95%CI=1.087~1.567)、大学及以上(OR=1.443,95%CI=1.222~1.705)、农业户口(OR=1.330,95%CI=1.219~1.451)、有配偶(OR=1.239,95%CI=1.074~1.431)、至少接受过一项健康教育(OR=2.352,95%CI=1.934~2.860)和已建立健康档案(OR=42.335,95%CI=37.245~48.121)的流动人口更愿意签约家庭医生;户籍地参保(OR=0.832,95%CI=0.756~0.915)、省内跨市流动(OR=0.877,95%CI=0.792~0.971)、家庭人均月收入大于1 000元和因工作原因流动(OR=0.426,95%CI=0.305~0.596)的流动人口更不愿意签约家庭医生.决策树模型显示健康档案是流动人口签约的最主要影响因素,其次是流动原因、是否接受健康教育以及家庭人均月收入.结论 我国中部地区流动人口家庭医生签约水平仍有待提高,"知而不签"现象较为普遍.建议从加大政策宣传普及力度、丰富签约服务内容、协同推进基本公共卫生服务等方面改善流动人口家庭医生服务签约率低的现状.
Status quo and influencing factors of family doctor contracting for migrants in the central region of China
Objective To analyze the status quo of family doctor contracting for the migrants in the cen-tral region of China and its influencing factors,in order to provide reference for better realizing the equalization of basic public health services for the migrants and improving the status quo of family doctor contracting for them.Methods Based on the data of the 2018 China Migrants Dynamic Survey,the migrants flowing into the central re-gion of China with a mobility time of ≥6 months was screened,and a logistic regression model and a decision tree model were established respectively with the SPSS 26.0 software to analyze the influencing factors for the migrants signing up for a family doctor.Results Among the migrants in the central region of China,the rate of signing up for a family doctor was 19.68%,and the knowledge rate was 46.88%.logistic regression analysis results showed that migrants with age ≥45 years(OR=1.305,95%CI=1.087~1.567),university education and above(OR=1.443,95%CI=1.222~1.705),agricultural household(OR=1.330,95%CI=1.219~1.451),and those having a spouse(OR=1.239,95%CI=1.074~1.431),having received at least one health education(OR=2.352,95%CI=1.934~2.860),and having established health records(OR=42.335,95%CI=37.245~48.121)were more willing to sign up for a family doctor;those who were insured in their domicile(OR=0.832,95%CI=0.756~0.915),who were migrating within the province and across cities(OR=0.877,95%CI=0.792~0.971),whose per capita monthly household income was higher than 1 000 RMB,and who migrated for work(OR=0.426,95%CI=0.305~0.596)were more reluctant to sign up for a family doctor.The decision tree model showed that health record was the main influence factor for the migrants to sign up for a family doctor,followed by the reason for mobility,whether or not to receive health education,and per capita monthly household income.Conclusions The rate of family doctor contracting among the migrants in the central region of China still needs to be improved,and the phenomenon of"knowing but not signing"is more common.It is recommended to improve the low signing rate by increasing the popularization of the policy,enriching the content of the contracted services,and coordinating the promotion of basic public health services.

Central regionLogistic regressionDecision tree modelMigrantsFamily doctorInfluen-tial factor

李凤红、钟杰、郑先平

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江西中医药大学医药卫生管理与政策发展研究中心,江西南昌 330004

南开大学卫生经济与医疗保障研究中心,天津 300350

中部地区 logistic回归 决策树模型 流动人口 家庭医生 影响因素

2024

中国农村卫生事业管理
中华预防医学会

中国农村卫生事业管理

影响因子:0.744
ISSN:1005-5916
年,卷(期):2024.44(12)