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目的了解东莞市中老年人对社区卫生服务利用及满意度的影响因素,为养老服务体系的建设规划提供依据。方法随机抽取东莞市55岁以上中老年人,通过问卷调查社区卫生服务首诊率和满意度,并对其影响因素进行分析。结果共调查798名中老年人,其中发生疾病时首诊选择社区卫生服务机构的有16.6%;其中就职单位属性为民营企业的中老年人社区卫生服务首诊率比就职党政机关的高(OR=3.701,P=0.023);而享受公费医疗的比使用城镇职工保险低(OR=0.434,P=0.025);健康状况一般化、不健康的均比健康人群低(OR=0.496,P=0.020,OR=0.321,P=0.035);首诊单位选择原因中认为是价格低的比因医保定点单位的高(OR=3.352,P<0.001)。影响中老年人对社区卫生服务机构满意度的因素分析中,健康状况为一般化的中老年人满意度低于健康人群(OR=0.488,P=0.016);家庭月收入为15 000~20 000元的低于30 000元以上的(OR=0.059,P=0.018)。结论就职单位属性、医疗费用支付方式、健康自评、选择首诊单位原因是影响中老年人首诊选择社区服务机构的主要因素。健康自评、家庭月收入是影响中老年人对社区卫生服务满意度的主要因素。
Objective To understand the influential factors of community health service utilization and satisfaction in middle-aged and elderly people in Dongguan and provide the basis for the planning and construction of pension service system. Methods The middle-aged and elderly people aged over 55 in Dongguan were randomly selected. The first visit rate and satisfaction of community health service were surveyed by questionnaire, and the influencing factors were analyzed. Results A total of 798 middle-aged and elderly people were surveyed. Among them, 16.6% of the community-based health service institutions were selected as the first diagnosis when illness occurred. Among them, the first visiting rate of community health services among middle- OR = 3.701, P = 0.023); while the public health insurance was lower than that of urban workers (OR = 0.434, P = 0.025); the general health status and the unhealthy status were lower than those in the healthy population (OR = 0.496, P = 0.020) , OR = 0.321, P = 0.035). The reason for choosing the first diagnosis unit was the low price because of the high fixed-point unit (OR = 3.352, P <0.001). In the analysis of factors that affect the satisfaction of middle-aged and elderly people in community health service agencies, the satisfaction of the generalized middle-aged and elderly was lower than that of healthy people (OR = 0.488, P = 0.016); the monthly family income was 15 000-20 000 Yuan less than 30 000 yuan (OR = 0.059, P = 0.018). Conclusion The reasons for choosing the first clinic unit are the factors that influence the first visit of middle-aged and elderly people to choose community service institutions, such as the attribute of the employed unit, the way of payment of medical expenses, self-evaluation of health. Health self-assessment, family monthly income is the main factor affecting the satisfaction of community health services among middle-aged and elderly people.