摘要
背景 随着人口老龄化加剧和疾病谱的变化,老年慢性病共病发病率居高不下,已成为基层家庭医生签约服务的重点关注人群。目前,从增“量”角度分析家庭医生签约的研究较多,但尚缺乏从提“质”角度入手,对签约后老年慢性病共病患者家庭医生签约服务的成效进行研究。目的 探索广东省社区老年慢性病共病患者对家庭医生签约服务的满意度和有用性评价的重要影响因素,为今后基层老年慢性病共病管理服务提供改进依据。方法 于2022年9—12月,采用多阶段分层整群随机抽样方法,选取广东省(深圳市、湛江市、梅州市)社区老年慢性病共病患者为调查对象,采用自行设计的问卷进行调查。采用多因素Logistic回归分析探讨老年慢性病共病患者家庭医生签约服务满意度和有用性评价的影响因素。结果 共收回有效问卷636份,有效回收率99.69%(636/638)。家庭医生签约服务满意度评价为比较满意/非常满意624人,占比98.11%;家庭医生签约服务有用性评价为略有帮助/帮助很大625人,占比98.27%。多因素Logistic回归分析结果显示,以对家庭医生签约服务满意度为一般的患者为参照,患高脂血症(OR=15.203)、患病时间<3年(OR=48 703 577.681)、患4种慢性病(OR=135.131)以及自理能力为重度依赖(OR=668 738.913)的患者相对于完全自理的患者易做出比较满意的评价,个人年均收入为≤3万元(OR<0.001)、>3万~5万元(OR<0.001)、>5万~10万元(OR<0.001)的患者相对于收入>10万~20万元的患者更不容易做出比较满意的评价(P<0.05);65~69岁的患者(OR=12.573)相对于≥70岁的患者,以及患4种慢性病(OR=135.131)相对于患5种及以上慢性病患者易做出非常满意的评价,而对于个人年平均收入为≤3万元(OR<0.001)、>3万元~5万元(OR<0.001)和对病情了解一些(OR=0.013)或比较了解(OR=0.035)的患者相对不容易做出非常满意的评价(P<0.05)。以老年慢性�
Background With the aging of the population and changes in the disease spectrum,the incidence of multimorbidity among the elderly remained high,and have become the focus of the family doctor contracting service at the primary level.At present,there are many studies promoting the signing of family doctors from the perspective of increasing "quantity",but there is still a lack of studies on the factors affecting the effectiveness of family doctor contract services for elderly multimorbidity patients after signing from the perspective of improving "quality".Objective To explore the important influencing factors of satisfaction and usefulness evaluation of elderly multimorbidity patients with family doctor contract services in urban communities of guangdong province,and to provide a basis for future improvement of multimorbidity management services at the grassroots level.Methods From September to December 2022,elderly patients with multiple chronic conditions in the community of Guangdong Province(Shenzhen,Zhanjiang and Meizhou)were selected by multi-stage stratified whole cluster random sampling method and surveyed by self-administered questionnaire.Multifactorial Logistic regression analysis was used to explore the influencing factors of satisfaction and usefulness evaluation of family doctor contracting services for elderly multimorbidity patients.Results A total of 636 valid questionnaires were collected,with effective recovery rate of 99.69%(636/638).There were 624family doctors who were relatively satisfied/very satisfied,accounting for 98.11%;The service usefulness evaluation of family doctors was slightly helpful/greatly helpful to 625 people,accounting for 98.27%.The results of multivariate Logistic regression analysis showed that patients with general satisfaction of family doctor contract service were taken as reference.Patients with hyperlipidemia(OR=15.203),disease duration <3 years(OR=48 703 577.681),4 chronic diseases(OR=135.131),and severe dependence on self-care ability(OR=668 738.913)were more like
作者
谢可欣
杜芳
张丹
XIE Kexin;DU Fang;ZHANG Dan(Institute for Hospital Management of Tsinghua University/Tsinghua Shenzhen International Graduate School,Shenzhen 518000,China;Shenzhen Health Development Research and Data Management Center,Shenzhen 518000,China)
出处
《中国全科医学》
CAS
北大核心
2024年第20期2512-2519,2526,共9页
Chinese General Practice
基金
国家自然科学基金资助项目(72004112)。
