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中国东南部门诊患者中社区卫生服务中心的响应性及其相关因素:一项横断面研究

Community Health Centers' Responsiveness and Its Associated Factors Among Outpatients in Southeast China: A Cross-Sectional Study.

作者信息

Zhou Chi, Li Xu, Shen Wenli, Huang Qunfang, Lin Xiaoling, Zhang Gaofeng, Dong Yin

机构信息

Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People's Republic of China.

Department of Health Development, Hangzhou Xixi Hospital, Hangzhou, Zhejiang, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2024 Aug 26;17:2023-2034. doi: 10.2147/RMHP.S475289. eCollection 2024.

Abstract

BACKGROUND

The responsiveness of community health centers can reflect the soft capacity of medical institutions and is related to the improvement of health outcome indicators. This study is aimed at assessing the level and distribution of community health centers' responsiveness and its associated factors among outpatients under the health-oriented integrated healthcare system in China.

METHODS

A total of 634 outpatients were recruited from six community health centers in Zhejiang Province, China, in July 2022. SPSS software was used to conduct the analysis (version 23.0). Health system responsiveness was used as a measure of outpatient responsiveness to health care services through a self-administered questionnaire. Determinants of community health centers' responsiveness were determined by using a multiple linear regression model at a -value <0.05.

RESULTS

The total score of community health centers responsiveness was 8.25±1.01, and the Gini coefficient is 0.027. Within these domains, social support and dignity received the highest scores, while choice of providers and autonomy scored the lowest. Age group between 60-74 years (β: 0.129; 95% CI: 0.042-0.529), ≥75 years (β: 0.095; 95% CI: 0.006-0.707), monthly income with 8000 RMB and above (β: 0.098; 95% CI: 0.035-0.653), having a family doctor (β: 0.124; 95% CI: 0.096-0.410), and satisficing with community health service (β: 0.298; 95% CI: 0.848-1.428) were significant predictors of community health centers' responsiveness.

CONCLUSION

The Chinese community health centers show high responsiveness, indicating that the construction of a health-oriented integrated healthcare system has been effective. The family doctor contract service is important and should continually enhance both technical proficiency and health promotion capabilities. Encourage residents to actively participate in their treatment process is also essential.

摘要

背景

社区卫生中心的响应性能够反映医疗机构的软实力,且与健康结局指标的改善相关。本研究旨在评估中国以健康为导向的整合医疗体系下社区卫生中心响应性的水平、分布及其相关因素。

方法

2022年7月,在中国浙江省的6家社区卫生中心招募了634名门诊患者。使用SPSS软件(版本23.0)进行分析。通过自填式问卷,将卫生系统响应性作为门诊患者对医疗服务响应性的一项衡量指标。采用多元线性回归模型确定社区卫生中心响应性的决定因素,P值<0.05。

结果

社区卫生中心响应性的总分为8.25±1.01,基尼系数为0.027。在这些维度中,社会支持和尊严得分最高,而提供者选择和自主权得分最低。60 - 74岁年龄组(β:0.129;95%置信区间:0.042 - 0.529)、≥75岁年龄组(β:0.095;95%置信区间:0.006 - 0.707)、月收入8000元及以上(β:0.098;95%置信区间:0.035 - 0.653)、有家庭医生(β:0.124;95%置信区间:0.096 - 0.410)以及对社区卫生服务满意(β:0.298;95%置信区间:0.848 - 1.428)是社区卫生中心响应性的显著预测因素。

结论

中国社区卫生中心显示出较高的响应性,表明以健康为导向的整合医疗体系建设取得了成效。家庭医生签约服务很重要,应不断提高技术水平和健康促进能力。鼓励居民积极参与其治疗过程也至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46c5/11363914/7df55554447f/RMHP-17-2023-g0001.jpg

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