摘要
目的:调查天津市老年慢性病患者出院后对家庭医生签约服务的利用情况及满意度,为促进家庭医生签约服务的开展提供决策依据。方法:2022年11月-2024年3月,于天津市南开区、静海区、西青区选定1493名老年慢性病患者为对象进行问卷调查,应用描述性统计方法及结构方程模型分析其对于家庭医生签约服务的利用情况与满意度评价情况,并探究其满意度的影响因素。结果:1493名老年慢性病患者出院后家庭医生签约服务近6个月内利用频数为(29.14±4.17)次,满意度总分为(101.72±9.42)分,医患关系及两者沟通交流、医疗保健服务、信息获取与支持、医疗服务连续性与合作性、服务组织等5个维度的满意度得分分别为(20.0±3.82)、(26.38±3.72)、(13.85±2.84)、(15.46±1.73)、(25.14±4.03)分。生活满意度对签约满意度的直接与间接效应均为正面影响(总效应0.71);最高学历对签约满意度的直接效应为负面影响(效应值-0.74),间接效应为正面影响(效应值0.29);婚姻情况、居住情况对签约满意度的直接效应为负面影响(效应值-0.49、-0.12);自评健康状况对签约满意度的直接效应为正面影响(效应值0.64)。结论:天津市老年慢性病患者出院后对家庭医生签约服务的利用情况良好,满意度处于中等水平。居住情况、婚姻情况、自评健康状况、最高学历和生活满意度是满意度的重要影响因素。医疗机构应聚焦老年群体身心需求,着重关注独居及体质健康情况欠佳者,优化医疗措施,规划更高水准的医疗服务流程,以推动家庭医生签约服务在天津市长远稳定地发展。
Objective:To investigate the utilization and satisfaction of family doctor contract services among older adults with chronic diseases after hospital discharge in Tianjin,and provide a basis for decision-making to promote the implementation of these services.Methods:From November 2022 to March 2024,a questionnaire survey was conducted with 1493 elderly chronic disease patients discharged from hospitals in Nankai,Jinghai,and Xiqing districts of Tianjin.Descriptive statistics and structural equation modeling were used to analyze their utilization and satisfaction with family doctor contract services and identify influencing factors.Results:For the 1493 elderly chronic disease patients after hospital discharge,the frequency of utilization of family doctor contract services in the past 6 months was(29.14±4.17)times.The total satisfaction score was(101.72±9.42),with satisfaction scores in five dimensions:doctor-patient relationship and communication(20.0±3.82),medical care services(26.38±3.72),information access and support(13.85±2.84),continuity and cooperation in medical services(15.46±1.73),and service organization(25.14±4.03).Life satisfaction positively influenced family doctor contract service satisfaction both directly and indirectly(total effect 0.71).The highest education level had a negative direct effect on satisfaction(-0.74)but a positive indirect effect(0.29).Marriage and living situation negatively affected contract satisfaction(-0.49,-0.12),while self-rated health status positively impacted satisfaction(0.64).Conclusion:The family doctor contract services are well utilized among elderly chronic disease patients after hospital discharge in Tianjin,with an overall moderate level of satisfaction.Key factors influencing satisfaction include residence status,marital status,self-rated health,education level,and life satisfaction.Medical institutions should focus on the physical and mental needs of the elderly,particularly those living alone or with poor health,optimize medical measures,and develop higher-standard procedures to ensure the stable and sustainable development of family doctor contract services in Tianjin.
作者
敬晔祺
李书
杨胜雯
王皓扬
JING Yeqi(School of Nursing,Tianjin University of Traditional Chinese Medicine,Tianjin,301617,China)
出处
《医学与社会》
北大核心
2025年第8期23-31,共9页
Medicine and Society
基金
天津市教委科研计划项目,编号为2022KJ156。
关键词
家庭医生签约服务
慢性病管理
满意度
老年人
天津
Family Doctor Contract Service
Chronic Disease Management
Satisfaction
Older Adult
Tianjin
