The Investigation On The Present Utilization Situationon And Influencing Factors Of Family Doctor Service In The Pilot Areas Of Guangzhou

Objective: to understand the present utilization situationon and influencing factors of family doctor service in the pilot areas of Guangzhou,we made some investigations so as to provide scientific basis for further improvement of family doctor service system.Methods: using stratified random sampling method,selected Guangzhou city Tianhe District,Baiyun District,Haizhuqu District,Whampoa District,Liwan District,Yuexiu District and Panyu District 7 districts in 23 community health service centers,to come to visit the 552 residents as research object.The self-designed questionnaire of family physician service was used to investigate the residents,The survey includes the following contents:(1)the basic situation.Demographic characteristics,health status,medical habits.(2)the awareness of different types of family physician services,the signing of the contract,the contract evaluation and satisfaction of contracted residents.(3)for different groups of family doctor cognitive degree,whether or not to accept the community first diagnosis,economic status,health insurance and other types of relations with the intention of signing;by multivariate logistic regression analysis,find out the influence of urban and rural residents in Guangzhou city.The main sign the family doctor service factors.(4)through the analysis of the residents' cognition and expectation of family doctors,the service content and service form of the family doctor service,which is the most urgent need of the residents,should be grasped.Results: the survey of 552 people,330 residents called signing,accounts for about 59.9% than that with 222 residents called the signing,accounted for 40.1%;Stepwise Logistic regression analysis showed that:(1)the different administrative areas,marital status,level of education,the employment situation is different,medicare,and different family income per capita and medical expense total household expenditure will be different for residents to choose whether or not signing family doctors have a significant impact,statistically significant difference(P < 0.05);(2)different household register(local or permanent)and self-evaluation of current economic situation is different compared to the signing of the inhabitants of willingness,there was no statistically significant difference.(P > 0.05)and(3)whether know signing the doctor's residents and the accessibility to the nearest community health service institutions at different levels,different relations with the doctor,and the overall evaluation of the family doctor service satisfaction are different on the sample whether residents choose to sign up family doctors have a significant impact,statistically significant difference(P < 0.05);(4)the current health status will of signing of different samples of residents,compared the difference was not statistically significant.(P > 0.05),(5)in the evaluation of overall satisfaction,feel satisfied and very satisfied,438 people(79.7%),there are 17(4.0%)for the family doctor service is not satisfied or less satisfaction;Residents for the family doctor service related project satisfaction from high to low order is in turn: service attitude,communication,service projects,waiting time,reimbursement,medical charges,service effects and medical level.(6)the demand of the residents in the sample package project evaluation,most people think that providing referral referral services,establish a residents electronic health records service,traditional Chinese medicine health care services and health physical examination assessment services division is needed,in the sample surveyed residents,only 54(9.8%)think domestic sickbed medical service is very necessary.(7)the smooth development of the family doctor service need to break through the cost,personnel and information platform,and many other bottlenecks.Conclusions and Suggestions:(1)the increased publicity,let people truly understand and accept the family doctor service;(2)improve the teaching quality of signing the family doctor service,let residents to experience the benefits of signing;(3)improve the family doctor service ability,gradually rich family doctor type sign forms and service methods;(4)strengthen the family doctor education training,improve the level of family doctor service;(5)improve the special funds investment and policy support,perfect the corresponding policies.