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目的调查与家庭医生对儿童保健提供服务相关的人口学和地理因素。方法使用美国家庭医生委员会2006—2009年收集的调查数据分析提供儿童保健服务的家庭医生所占的比例。用横断面研究设计及Logistic回归分析调查各种家庭医生人口学及地理因素与提供儿童保健服务之间的关系。结果年轻〔OR=0.97,95%CI(0.97,0.98)〕、女性〔OR=1.19,95%CI(1.12,1.25)〕、郊外地区〔OR=1.50,95%CI(1.39,1.62)〕为家庭医生提供儿童保健服务的影响因素。与他人合伙执业的家庭医生提供儿童保健服务的可能性比集体执业的家庭医生要高〔OR=1.53,95%CI(1.40,1.68)〕。儿童分布密度较高的家庭医生提供儿童保健服务的可能性较高〔OR=1.04,95%CI(1.03,1.05)〕,而在高贫困地区的家庭医生提供儿童保健服务的可能性较小〔OR=0.10,95%CI(0.10,0.10)〕。在无儿科医生地区的家庭医生提供儿童保健的可能性比在儿科医生分布密度较高地区的家庭医生更高〔OR=1.80,95%CI(1.59,2.01)〕。结论各种人口学及地理因素均能影响家庭医生提供儿童保健的可能性。找到这些影响因素对确保儿童获得健康保健的政策制定有重要的启示。
Objective To investigate the demographic and geographical factors associated with family doctor’s care for child health. Methods Using the survey data collected by the American Family Physicians Board in 2006-2009 to analyze the share of family physicians who provide child health services. Cross-sectional study design and Logistic regression analysis were used to investigate the relationship between various demographics and geography of family doctors and the provision of child health services. (OR = 1.97, 95% CI (0.97, 0.98)], female (OR = 1.19, 95% CI 1.12, 1.25) Influential factors for family doctors to provide child health services. Family doctors who practice partnerships with others are more likely to provide child health services than family practice doctors (OR = 1.53, 95% CI 1.40, 1.68). Family doctors with higher densities are more likely to provide child health services (OR = 1.04,95% CI (1.03,1.05)), while family doctors in low-lying areas are less likely to provide child health services [ OR = 0.10, 95% CI (0.10, 0.10)]. Family doctors in non-pediatricians are more likely to provide child health care than their family doctors in pediatricians with higher densities (OR = 1.80, 95% CI (1.59, 2.01)]. Conclusion Various demographic and geographical factors can affect the likelihood of family doctor providing child health care. Finding these factors has important implications for policy making to ensure children’s access to health care.