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林津晶, 赵慎非. 福州城区儿童家长对医疗服务相关政策认知分析[J]. 中国公共卫生, 2020, 36(11): 1543-1548. DOI: 10.11847/zgggws1123631
引用本文: 林津晶, 赵慎非. 福州城区儿童家长对医疗服务相关政策认知分析[J]. 中国公共卫生, 2020, 36(11): 1543-1548. DOI: 10.11847/zgggws1123631
LIN Jin-jing, ZHAO Shen-fei. Cognition on medical service-related policies among parents of children in urban Fuzhou[J]. Chinese Journal of Public Health, 2020, 36(11): 1543-1548. DOI: 10.11847/zgggws1123631
Citation: LIN Jin-jing, ZHAO Shen-fei. Cognition on medical service-related policies among parents of children in urban Fuzhou[J]. Chinese Journal of Public Health, 2020, 36(11): 1543-1548. DOI: 10.11847/zgggws1123631

福州城区儿童家长对医疗服务相关政策认知分析

Cognition on medical service-related policies among parents of children in urban Fuzhou

  • 摘要:
      目的  了解福建省福州城区儿童家长对医疗服务相关政策认知情况及其影响因素,为相关政策真正发挥实效提供思路。
      方法  于2017年8 — 10月,抽取福州城区936名 ≤ 14岁儿童家长为调查对象,运用logistic回归分析影响家长对儿童医疗服务满意度因素。
      结果  受访者对社区卫生机构医保报销情况、分级诊疗制度、家庭医生制度及基本药物制度的认知均不理想,完全不了解以上制度的比例分别达31.52 %、50.85 %、39.32 % 和83.65 %。有序logistic回归显示,家中儿童年龄4~6岁(OR = 0.524,95 % CI = 0.287~0.954)、公务员(OR = 0.007,95 % CI = 0.001~0.038)、事业单位员工(OR = 0.007,95 % CI = 0.001~0.035)及企业员工(OR = 0.003,95 % CI = 0.001~0.009)、文化程度为初中及以下(OR = 0.063,95 % CI = 0.014~0.286)、月收入 < 2 000元(OR = 0.016,95 % CI = 0.001~0.255)的受访者对社区卫生机构居民医保报销标准认知相对更低;全职在家(OR = 25.842,95 % CI = 2.518~265.199)、月收入4 000元~(OR = 3.743,95 % CI = 1.531~9.150)、将省级或市级医院(OR = 6.534,95 % CI = 1.810~23.589)、社区卫生机构(OR = 10.892,95 % CI = 2.941~40.337)作为儿童首选就诊机构的受访者对社区卫生机构居民医保报销标准认知相对较高。事业单位员工(OR = 0.101,95 % CI = 0.029~0.355)、企业员工(OR = 0.073,95 % CI = 0.031~0.175)、文化程度为高中/中专/技校(OR = 0.232,95 % CI = 0.069~0.777)和大专(OR = 0.107,95 % CI = 0.042~0.274)、家庭年收入为10万元~(OR = 0.207,95 % CI = 0.070~0.614)、儿童患病时首选就诊机构为省级或市级医院(OR = 0.247,95 % CI = 0.070~0.872)的受访者对分级诊疗的认知相对更显不足;儿童年龄1~3岁(OR = 3.254,95 % CI = 1.515~6.989)、儿童健康状况良好(OR = 15.549,95 % CI = 5.375~44.985)、家中儿童有参加居民医保(OR = 2.042,95 % CI = 1.291~3.231)的受访者对分级诊疗的认知相对较理想。文化程度为初中及以下(OR = 0.008,95 % CI = 0.001~0.081)、高中/中专/技校(OR = 0.088,95 % CI = 0.030~0.254)、大专(OR = 0.311,95 % CI = 0.137~0.706)、月收入为2 000元~(OR = 0.150,95 % CI = 0.062~0.363)和4 000元~(OR = 0.206,95 % CI = 0.092~0.460)、家中儿童有参加居民医保(OR = 0.560,95 % CI = 0.377~0.833)的受访者对家庭医生的认知相对更低。
      结论  城区儿童家长对医疗服务相关政策的认知不理想,相关制度的宣传未能到位,家长认知的不足有可能导致制度未能真正发挥实效,影响了家长对于儿童合理就医理念的形成及儿童医疗福利。

     

    Abstract:
      Objective  To examine the cognition on medical service-related policies and its influencing factors among parents of children in urban Fuzhou municipality of Fujian province and to provide evidences for effective implementation of the policies.
      Methods  We conducted a self-administered questionnaire survey on cognition on medical service-related policies among 936 parents of children ≤ 14 years old in urban regions of Fuzhou city between August and October 2017. Logistic regression analysis was used to analyze the satisfaction to medical service received by their children.
      Results  Of all the respondents, 31.52%, 50.85%, 39.32%, and 83.65% were not aware of medical insurance reimbursement for medication at community health institutions, tiered diagnosis and treatment scheme, family doctor service, and essential medicine system at all. Ordial logistic regression demonstrated that the respondents with the children aged 4 – 6 years (odds ratio OR = 0.524, 95% confidence interval 95% CI: 0.287 – 0.954), being civil servants (OR = 0.007, 95% CI: 0.001 – 0.038), working in public institutions (OR = 0.007, 95% CI: 0.001 – 0.035), employed by enterprises (OR = 0.003, 95% CI: 0.001 – 0.009), with the education of junior high school education or below (OR = 0.063, 95% CI: 0.014 – 0.286), and having monthly income of below 2 000 yuan (RMB) (OR = 0.016, 95% CI: 0.001 – 0.255) were more likely to have a lower cognition on the reimbursement standard for medication at community health institutions by urban residents′ medical insurance, while the respondents doing full-time housework (OR = 25.842, 95% CI: 2.518 – 265.199), having monthly income of 4 000 yuan or more (OR = 3.743, 95% CI: 1.531 – 9.150), selecting provincial/municipal hospitals (OR = 6.534, 95% CI: 1.810 – 23.589) or community health institutions (OR = 10.892, 95% CI: 2.941 – 40.337) as the first choice when their children needing medical service were more likely to have a higher cognition on the reimbursement standard; the respondents employed by public institutions (OR = 0.101, 95% CI: 0.029 – 0.355) or enterprises (OR = 0.073, 95% CI: 0.031 – 0.175), with the education of senior high school /technical secondary school/technical school (OR = 0.232, 95% CI: 0.069 – 0.777) or junior college (OR = 0.107, 95% CI: 0.042 – 0.274), having annual family income more than 100 000 yuan (OR = 0.207, 95% CI: 0.070 – 0.614), and selecting provincial/municipal hospitals as the first choice when their children needing medical service (OR = 0.247, 95% CI: 0.070 – 0.872) were more likely to have a lower cognition on tiered diagnosis and treatment scheme, whereas the respondents with the children aged 1 – 3 years (OR = 3.254, 95% CI: 1.515 – 6.989), the children in good health condition (OR = 15.549, 95% CI: 5.375 – 44.985), and the children participating in medical insurance for urban residents (OR = 2.042, 95% CI: 1.291 – 3.231) were more likely to have a higher cognition on tiered diagnosis and treatment scheme; the respondents with the education of junior high school and below (OR = 0.008, 95% CI: 0.001 – 0.081) or senior high school/technical secondary school/technical secondary school (OR = 0.088, 95% CI:0.030 – 0.254) or junior college (OR = 0.311, 95% CI: 0.137 – 0.706), with the monthly income of 2 000 – 3 999 yuan (OR = 0.150, 95% CI: 0.062 – 0.363) or 4 000 yuan and more (OR = 0.206, 95% CI: 0.092 – 0.460), and with the children participating in medical insurance for urban residents (OR = 0.560, 95% CI: 0.377 – 0.833) were likely to have a lower cognition on family doctor service.
      Conclusion  The parents of children in urban Fuzhou municipality are lack of awareness on medical service-related policies, suggesting that education programs on the government policies should be promoted among the population.

     

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