Research On The Medical And Health Service Intention Of Residents Under Primary Medical Institutions Service Area Based On A Medical Association

Objective:This study aimed to understand the current situation of chronic diseases and the demand for medical services among residents in Zhengzhou,and to explore the main influencing factors of the demand for medical services and the demand willingness of family doctors.In order to provide data support for the prevention and treatment of chronic diseases and medical and health development in Zhengzhou,and provide theoretical support for the corresponding health and health development planning and health policy.Methods:Questionnaire investigation was used collected for health and medical service demand of Zhengzhou city residents according to the patients source of the people's hospital of Zhengzhou 2015.In this study,Jinshui district of Zhengzhou city residents were selected as the research object through two-stage random sampling method.Two communities from Jinshui district were randomly sampled as the primary sampling unit,then a random sample of 1500 people were sampled from the chronic disease management key crowd health records in each community.Self-made medical service intention questionnaire was used to collect information from subjects.Ten invalid questionnaires were excluded and 2,990 valid ones were included.Qualitative and quantitative analysis,such as descriptive analysis,chi-square analysis,Logistic regression analysis and other methods were used to study the medical service demand and it's influencing factors of residents in Zhengzhou.All the data preprocessing and analysis were conducted in SPSS21.0 software.Results:1.A total of 2,990 valid questionnaires were collected in this survey,among which 1,067 were male,accounting for 35.7%,and 1,923 were female,accounting for 64.3%.Among the subjects,the proportion of retirees was the highest(39.3%).There are differences in geographical area,age,medical insurance type,physical examination intention and family doctors demand according to the gender distribution.2.The self-rated health status of the subjects was good overall,with 7.4% of the self-rated health status as "bad" and 0.5% as "very bad".Public hospitals were the first choice of medical institutions for the subjects(58.1%).3.The reason for seeking medical treatment is mainly illness(accounting for 69.2%).The reason for seeking medical treatment is different in geographical area,age,income level,type of medical insurance,self-assessment of health,preferred medical institution,annual health care expenditure level,physical examination intention and demand of family doctors.4.Reasons for seeking medical treatment and demand for family doctors are affected by various factors.The average monthly income,self-assessed health status,physical examination willingness,type of medical insurance,demand willingness of family doctors and annual health care expenditure are the main influencing factors of the reasons for seek medical treatment,while the self-assessed health status,reasons for seeking medical treatment and physical examination willingness are the main influencing factors of the demand willingness of family doctors.Conclusions:Public hospitals are still the preferred medical institutions for residents to seek medical treatment,and medical technology and service attitude have become the primary factors for residents to choose medical institutions.Patients tend to flow to large hospitals,and the service capacity of community health service centers and other grassroots medical and health institutions needs to be further improved.The average monthly income,self-assessed health status,physical examination willingness,type of medical insurance,demand willingness of family doctors and annual health care expenditure are the main influencing factors of the willingness to seek medical treatment,while the self-assessed health status,reasons for seeking medical treatment and physical examination willingness are the main influencing factors of the demand willingness of family doctors.It is urgent to strengthen policy publicity and residents' health education,and accelerate the implementation of family doctor contract service.