首页|不同年龄段就诊居民社区卫生服务的反应性评价现状与影响因素研究

不同年龄段就诊居民社区卫生服务的反应性评价现状与影响因素研究

Responsiveness Assessment and Its Influencing Factors of Community Health Services among Residents of Different Ages

扫码查看
背景 反应性作为卫生系统绩效评价的重要目标,是提高基层卫生服务能力的重要依据,目前许多研究将反应性与满意度的概念混淆,对反应性的评价不够全面,注重研究反应性水平忽视了反应性分布.目的 了解浙江省不同年龄段就诊居民对社区卫生服务的反应性评价现状,并分析其影响因素.方法 采用立意抽样与方便抽样相结合的方法,于 2022 年 7-8 月选取浙江省杭州市和台州市的 6 家社区卫生服务中心作为调查现场,对门诊就诊居民进行反应性量表调查;采用WHO推荐的反应性 8 个部分的权重计算反应性总体水平和分布,采用单因素分析和多元线性回归分析探讨不同年龄段居民对社区卫生服务的反应性评价的影响因素.结果 浙江省就诊居民对社区卫生服务的反应性评分为(8.31±1.04)分,反应性分布指数为 0.13;各年龄段就诊居民均对尊严与社会支持维度评分较高,分别为(8.60±1.24)分和(8.63±1.20)分,对选择性和自主性维度评分较低,分别为(7.96±1.56)分和(8.04±1.34)分.户口是青年人对社区卫生服务的反应性评价的影响因素,文化程度和月收入是中年人对社区卫生服务的反应性评价的影响因素(P<0.05).结论 浙江省社区卫生服务的反应性总体水平较高且分布较均衡,需对城镇户口的青年人、大专/本科及以上的中年人的社区卫生服务需求及反应性多加关注.基层社区卫生服务中心在让患者获取医疗健康服务方案信息以及自由选择社区医生/护士方面还有待提高,以更好满足居民合理的卫生健康服务需求.
Background Responsiveness is a key goal in evaluating the performance of the health system,and is also an essential basis for improving the capacity of primary health services.Currently,many studies confuse the concepts of responsiveness and satisfaction,and the evaluation of responsiveness is not comprehensive enough,focusing on the level of responsiveness but ignoring its distribution.Objective To understand the responsiveness evaluations of community health services among residents of different ages in Zhejiang province and to analyze its influencing factors.Methods Utilizing the method of purposive sampling and convenience sampling,six community health service centers in Hangzhou and Taizhou,Zhejiang province,were selected as the investigation sites from July to August 2022 to assess the responsiveness scale of outpatient residents.The weights of the eight components of responsiveness recommended by the WHO were used to calculate the overall level and distribution of responsiveness.Univariate analysis and multiple linear regression were used to explore the influencing factors on the responsiveness level among residents of different ages.Results The score of responsiveness for community health services in Zhejiang was(8.31±1.04)points,and the responsiveness distribution index was 0.13;residents of different age groups expressed their higher satisfaction with the dimensions of dignity and social support,with scores of(8.60±1.24)points and(8.63±1.20)points,respectively.In contrast,the dimensions of selectivity and autonomy received lower ratings,with scores of(7.96±1.56)points and(8.04±1.34)points,respectively.Household registration was an influencing factor for responsiveness evaluation of community health services among young people,while education level and monthly income were influencing factors for responsiveness evaluation among middle-aged individuals(P<0.05).Conclusion The overall level of community health service responsiveness in Zhejiang province is good,and the distribution is more balanced.More attention should be paid to the demand and responsiveness of community health services among young people with urban household registration and middle-aged people with a college/bachelor's degree or above.Primary care community health service centers still need to improve in providing patients with access to information about health service plans and the freedom to choose community doctors/nurses,thereby better satisfying the reasonable healthcare service demands of residents.

Community health servicesResponsivenessCross-sectional studiesRoot cause analysisMultiple linear regression

施译楠、周驰

展开 >

311121 浙江省杭州市,杭州师范大学公共卫生学院健康管理系

社区卫生服务 反应性 横断面研究 影响因素分析 多重线性回归

国家自然科学基金面上项目教育部人文社会科学研究青年基金

7227405022YJCZH262

2024

中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子:2.04
ISSN:1007-9572
年,卷(期):2024.27(31)