上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (10): 1452-.doi: 10.3969/j.issn.1674-8115.2011.10.021

• 论著（卫生事业管理） • 上一篇    下一篇

社会支持网络视角下的30分钟就医圈内老年人社区卫生选择动因研究

何亚平, 沈 恬, 刘 威, 鲍 勇   

  1. 上海交通大学 |公共卫生学院, 上海 200052
  • 出版日期:2011-10-28 发布日期:2011-10-27
  • 通讯作者: 鲍 勇, 电子信箱: baoyong@stju.edu.cn。
  • 作者简介:何亚平（1964—）, 女, 博士, 副教授；电子信箱: hypcyr@hotmail.com。
  • 基金资助:

    上海市教委基金（08ys50）

Study on motives for senior citizens' choice of community health services available within 30 minutes from social support network perspective

HE Ya-ping, SHEN Tian, LIU Wei, BAO Yong   

  1. School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2011-10-28 Published:2011-10-27
  • Supported by:

    Shanghai Education Committee Foundation, 08ys50

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摘要：

目的 探讨30 min就医圈内老年人选择社区卫生服务的动因和影响因素。方法 采取整群抽样方法，依据社会支持网络的分析范式，在上海市卢湾区社区卫生服务中心就诊的≥60岁的老年人中，筛选步行30 min范围内既可以到达一家综合医院，也可以达到一家社区卫生服务中心的709位老年人进行问卷调查。结果 老年居民选择社区卫生服务中心的前3位的原因是距离近和方便可及（85.9%）、服务态度（72.8%）以及经济实惠（41.2%）；首诊选择综合性或专科医院的原因则依次为技术力量强（78.3%）、设备先进（61.3%）以及治疗效果好（45.3%）。有无慢性病、等候时间长短和社区卫生服务中心年就诊次数对社会赞许度的选择有影响（P＜0.01）。结论 社区卫生服务网络的特征是高强度、低密度和低互动性，网络在30 min就医圈里的稳定性并不出色，其中等候时间成为影响网络稳定性的重要指标，服务要求中老年人更关注情感支持和信息传递的功能。

关键词: 30分钟就医圈, 老年人, 社区卫生, 社会支持网络

Abstract:

Objective To explore the motives and influencing factors for senior citizens' choice of community health services available within 30 min. Methods Based on cluster sampling and social support network analysis paradigm, and among the senior citizens aged 60 and above receiving medical treatment in community health centers of Luwan District of Shanghai, 709 people who could reach both a general hospital and a community health center within 30 minutes' walk were selected and surveyed with a questionnaire. Results The top three reasons for senior citizens to choose community health centers were as follows: close distance and high accessibility（85.9%）, service attitude （72.8%） and affordability (41.2%). While general hospitals were chosen due to their excellent techniques (78.3%), equipments (61.3%) and treatment outcomes (45.3%). Factors like suffering from chronic diseases, time of waiting and annual times of visit to community health centers had relatively greater influence on their choice （P＜0.01）. Conclusion At present, the community health services network is characterized by high intensity, low density and low interactivity. The stability of community health services network is not remarkable compared with the other health services available within 30 min. Time of waiting is an important factor influencing the stability of the network. Senior citizens are more concerned about the emotional support and information transmission of community health services.

Key words: health service within 30 minutes, senior citizen, community health, social support network