A Study Of Willingness To Community Health Services For Beijing Residents And Doctors

Objective: To know the awareness,utilization and satisfaction for community healthservices among Beijing residents, and the status of community health services at present, toexplore the influential factors for them to utilize community health services, to analyzeresidents' and doctors' attitudes to the first contact medical care at the community and thereferral of medical care, to know doctors' attitudes to interaction between hospital andcommunity health centers(CHCs). To propose suggestions on health policy for developingcommunity health services, and on the reform of medical care system.Materials and Methods: Questionnaire investigation was used in this study. Doctorsand patients from 6 hospitals and 8 CHCs in Dongcheng,Xicheng and Chaoyang districtwere investigated by self-administered questionnaires and face-to-face interview. Databasewas set up with ACCESS software, and data was input twice and checked up by differentpersons. Statistics processing was finished with SPSS version13.0. 508 subjects wereinvestigated, and 503 valid questionnaires were returned (158 for doctors and 345 forpatients). The return rate is up to 99.02ï¼….Results: (1)The main educational background of doctors in CHCs is technical college anduniversity, accounting for 48.57ï¼…and 42.86ï¼…respectively. Primary and medium-gradeconstitute the principle part of the professional title structure, accounting for 51.43ï¼…and40.00ï¼…respectively, and the proportion of senior professional title is just about 8.57ï¼….(2)The proportion of subjects who are willing to choose CHCs is account for 58.08ï¼…, whilethe opposite is 41.92ï¼…. The main reasons that they are not willing to choose CHCs are "thedoctors' technical level is low"(71.88ï¼…) and "lack of diagnosis equipment". (3)The proportion of subjects who know there are CHCs in their community,who know there areno CHCs in their community and who do not know if there are CHCs in their communityis account for 85.59ï¼…, 10.04ï¼…and 4.37ï¼…respectively. Subjects who have been to CHCbefore is account for 48.03ï¼…the other is 51.97ï¼…. (4)Over more than a half of doctorsthought the first contact medical care at the community is unnecessary and unfeasible. Thereasons are for that doctors working in CHCs may not make a right diagnosis on timebecause of their low technical level and lack of diagnosis equipment. (5)The informationtransmission and communication between hospital and CHCs is not well. Doctors workingin CHCs receive less information feedback from the hospital after patients' referral.(6)Most doctors think it is necessary to set up interaction between hospital and CHCs, andthey express their willingness to work at CHCs for certain time if possible.Conclusions: The low educational background and the low professional title ofdoctors in CHCs,the low technical level,lack of diagnosis equipment and the imperfectmedical insurance system are the influential factors affecting residents to choose andutilize community health services. The attitudes of the residents and doctors to the firstcontact care at the community are not positive. At present, these problems are obstacles forinteraction: the interaction net has not yet established, the information transmission systemis poor, the uniform standard and supervision system is not well, and the difference for themedical insurance reimbursement between hospital and CHCs is not obvious.