| Objective:According to Tiburt and kelly's description of the role,the subjects were survey ed by medical staff,hospital administrators and the public.One provincial general hos pital,one provincial specialized hospital and two community health service institution s were randomly selected as the research and investigation sites in Shanxi Province,and 1106 valid questionnaires were eventually collected with the effective recovery rate of 94.05%.The respondents included 665 members of the public(60.0%),380 me dical staff(34.4%)and 61 hospital administrators(5.6%).A total of 1176 questionnaire s were issued,of which 1106 were valid,with an effective recovery rate of 94.05%.I n this study,Epidate3.1,SPSS22.0 and SAS9.4 statistical software were used for data entry and analysis.Exploratory factor analysis and confirmatory factor analysis were used to evaluate the scale structure,reliability and validity.Methods:According to Tiburt and Kelly's description of the role,the subjects were survey ed by medical staff,hospital administrators and the public.One provincial general hos pital,one provincial specialized hospital and two community health service institution s were randomly selected as the research and investigation sites in Shanxi Province,and 1106 valid questionnaires were eventually collected with the effective recovery rate of 94.05%.The respondents included 665 members of the public(60.0%),380 me dical staff(34.4%)and 61 hospital administrators(5.6%).A total of 1176 questionnaires were issued,of which 1106 were valid,with an effective recovery rate of 94.05%.In this study,Epidate3.1,SPSS22.0 and SAS9.4 statistical software were used for data entry and analysis.Exploratory factor analysis and confirmatory factor analysis were used to evaluate the scale structure,reliability and validity.Results:1.The kronbach coefficient of reliability was 0.994 of the total questionnaire,0.V978 of cultural expectation,0.987 of service expectation,0.986 of management expect ation and 0.977 of social responsibility expectation,respectively.The mean square resi dual root(RMR)of each dimension of validity index is below 0.08,and the compariso n fitting index(CFI)and the goodness of fit index(GFI)are above or near 0.9,indicati ng that the reliability and validity have reached a good level of statistics.2.Cultural expectation of community health service institutions:the cultural exp ectation of urban residents was slightly higher than that of rural residents(P<0.05).T he public had higher cultural expectations of community health service institutions t han hospital medical personnel and managers(P<0.05);People?30years old had highe r cultural expectations of community health service institutions than people of other ages(P<0.05).The people with junior high school education had the highest cultural expectations for community health service institutions(P<0.05).Cultural expectations of community health service institutions were high among the non-working populati on(P<0.05).The healthy population and the frequently hospitalized population had hi gher cultural expectations of community health service institutions than the frequentl y outpatient population(P<0.05).Health status(X1)and different roles(X2)were the infl uencing factors of cultural expectation factors in multivariate analysis.3.Service expectations of community health service institutions:the public has higher expectations of diagnosis and treatment services and other services of comm unity health service institutions than medical staff and managers in hospitals(P<0.05);People younger than 30 years old had higher expectations on diagnosis and treatme nt services and other services in community health service institutions than those ag ed 31-40,41-50,51-60 and 51-60 years old(P<0.05).Those who had worked for less t han 5 years and those who had worked for 6-10 years had the highest expectations for diagnosis and treatment services and other services in community health servic e institutions compared with those who had worked for 11-20 years and those who had worked for more than 20 years(P<0.05).The healthy population had higher exp ectations on the diagnosis and treatment services and other services of community h ealth service institutions than the population who often went to outpatient clinics(P<0.05).In the multi-factor analysis,working years(X1),health status(X2)and different rol es(X3)were the influencing factors of diagnosis and treatment service factors,while h ealth status(X1)and different roles(X2),age(X3)and education level(X4)were the influe ncing factors of other service factors.4.Management expectations of community health service institutions:the public has higher management expectations of community health service institutions than h ospital medical personnel and managers(P<0.05);The population?30 years old had h igher expectations on the management of community health service institutions than the population of other ages(P<0.05).Those with junior high school education had t he highest expectation on the management of community health service institutions(P<0.05).The healthy population and the frequently hospitalized population had highe r expectations on the management of community health service institutions than the frequently outpatient population(P<0.05).In the multivariate analysis,different roles(X1)and health status(X2)are the influencing factors of the management expectation fac tor.5.Expectations of social responsibility of community health service institutions:cultural expectations of urban residents were slightly higher than those of rural resi dents(P<0.05);Population?30 years old had higher expectations on social responsibil ity of community health service institutions than other age groups(P<0.05).The peop le with junior high school education had the highest expectation on the social respo nsibility of community health service institutions(P<0.05).Healthy people,people who are often hospitalized,and people who often go to outpatient clinics have higher ex pectations on the social responsibility of community health service institutions than those who suffer from chronic diseases(P<0.05).In the multivariate analysis,health s tatus(X1)and education level(X2)are the influencing factors of social responsibility e xpectation factors.Conclusion:1.The public,medical staff and hospital managers have different expectations o n community health service institutions,among which the deficiencies of medical staf f's role understanding mainly focus on culture,management and social responsibility;Different ages and different health conditions have an impact on the expectations of community health service institutions,and the expectations of low-income,middle an d young people and urban residents are higher.Therefore,in the reform and develop ment of community health service institutions,the rectification measures should cover the whole population,and at the same time,they should pay more attention to the aspects with high expectations of social roles and insufficient understanding of thems elves.2.To promote the reform of community health service institutions,we should n ot only focus on the reform of large hospitals,but also give full play to the social responsibilities due to their important social roles under the law of health economy.At the same time,pay attention to the cultural construction,pay attention to the const ruction management,standardize the role behavior;Optimize health services,strengthen social responsibility,and define roles. |
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