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目的为了解居民对健康档案的认知和态度,探索建立完整健康档案的有效方法。方法采用分层随机抽样方法,于2014年7—8月从4个城区抽取2个城区的2个小区18岁以上居民作为调查对象。计数资料采用χ2检验,影响因素分析采用多因素Logistic回归,P<0.05为差异有统计学意义。结果 477人中,建立过健康档案的有208人,建档率为43.6%;48.8%(233/477)的居民了解健康档案,其中建立健康档案的为78.5%(183/233),未建立健康档案的21.5%(50/233);建立健康档案的居民健康内容知晓率(39.9%,73/183)显著高于未建立健康档案的居民(18.0%,9/50),差异有统计学意义(χ2=8.25,P<0.05)。未患慢性病对建立健康档案有影响(OR=28.819,95%CI为13.774~60.296);>50岁的居民(OR=0.212,95%CI为0.076~0.593;OR=0.130,95%CI为0.047~0.337)、购买新型农村合作医疗(新农合)保险(OR=0.340,95%CI为0.116~0.998)、农村居民(OR=0.310,95%CI为0.134~0.716)对建立健康档案有促进作用。建立健康档案的208人中有88人(42.3%)提出自己的需求,其中20.8%(22/106)希望社区医生加强健康知识宣传,19.8%(21/106)希望社区医生提供上门服务,17.9%(19/106)希望降低药价或提供免费药品,16.0%(17/106)希望增加免费检测项目,8.5%(9/106)认为应增加检测血糖(血压)次数和随访次数,8.5%(9/106)希望提高社区医生技术水平和检测设备改进,8.5%(9/106)希望提高社区医生服务态度。结论政府部门应加强宣传力度,提高居民对健康档案的知晓和认知程度,社区医生服务质量有待进一步提高。
Objective To understand the residents’ cognition and attitude towards health records and to explore effective ways to establish a complete health record. Methods Taken stratified random sampling method, from July to August 2014, residents in the two districts over 18 years of age in 2 urban districts were sampled from 4 urban districts as the survey subjects. Count data using χ2 test, multivariate logistic regression analysis of influential factors, P <0.05 for the difference was statistically significant. Results Of the 477 patients, 208 had health records, with a rate of 43.6%. Among them, 48.8% (233/477) had health records, of which 78.5% (183/233) had health records and did not establish 21.5% (50/233) of health records; residents’ awareness of health contents (39.9%, 73/183) was significantly higher than that of residents without health records (18.0%, 9/50) Significance (χ2 = 8.25, P <0.05). There was no effect of chronic diseases on the establishment of health records (OR = 28.819,95% CI 13.774 ~ 60.296); residents over 50 years of age (OR = 0.212, 95% CI 0.076-0.593; OR = 0.130,95% CI 0.047 ~ 0.337). The new rural cooperative medical care (NCMS) insurance (OR = 0.340, 95% CI 0.116-0.998) and rural residents (OR 0.310, 95% CI 0.134-0.716) effect. 88 (42.3%) of the 208 people who set up health records put forward their own needs. Of them, 20.8% (22/106) hoped that community doctors would strengthen the promotion of health knowledge and 19.8% (21/106) would like community doctors to provide on-site service and 17.9 % (19/106) hoped to reduce drug prices or provide free drugs, 16.0% (17/106) hoped to increase the number of free tests, 8.5% (9/106) thought that the number of blood glucose (blood pressure) tests and follow-up should be increased, 8.5% (9/106) Wants to Improve the Technical Level of Community Doctors and Test Equipment Improvements, 8.5% (9/106) Wants to Improve Community Doctors Service. Conclusion The government departments should step up publicity efforts to raise residents’ awareness and awareness of health records and the service quality of community doctors needs to be further improved.