Abstract：Objective To investigate the willingness for selecting a community doctor as a gatekeeper and its influencing factors among residents in Zhuhai City. Methods Multi-stage random sampling method was used to select permanent residents aged 15 years and above in seven administrative districts in Zhuhai City from March to May in 2015, and the self-designed questionnaire was employed to survey the willingness for first contact care of community and its influencing factors. The data were processed by SPSS 18.0, and descriptive analysis, χ2 test and logistic regression analysis were performed to determine the influencing factors. Results The awareness rate of the gatekeeper system in residents in Zhuhai City was low, only accounting for 28.00% of the population surveyed. After roughly understanding the gatekeeper system, 93.27% of the residents approved the implementation of the gatekeeper system and its gradual improvement. Single factor analysis revealed that the main factors affecting the residents’ first contact care of community were age, education background, per capita monthly income, type of insurance, suffering from chronic diseases, being satisfactory with medical skills of community health service institutions(CHIs)and believing that CHIs could meet the basic medical treatment requirements (P<0.05). Multivariate logistic regression analysis showed that residents with per capita monthly income more than RMB 5,000 Yuan (OR=0.56, 95%CI:0.36-0.89) were more reluctant to select a community doctor as a gatekeeper, while residents with urban medical insurance (OR=1.95, 95%CI:1.17-3.24), suffering from chronic diseases (OR=1.49, 95%CI:1.13-1.96), being gratified with medical skills of CHIs (OR=6.72, 95%CI:4.46-10.14) and believing that CHIs could meet the basic medical treatment requirements (OR=5.82, 95%CI:4.49-7.56) were more likely to choose first contact care of community. Conclusions The authority should ameliorate medical apparatus in the CHIs, improve their diagnosis and treatment level, and simultaneously intensify the publicity of the gatekeeper system and balance the encouragement and restraint of medical insurance so as to promote the implementation of the gatekeeper system in Zhuhai City.
滕勇勇, 叶浩森, 徐郁, 赵金利, 卢祖洵. 珠海市居民社区首诊意愿及其影响因素研究[J]. 实用预防医学, 2018, 25(9): 1050-1053.
TENG Yong-yong, YE Hao-sen, XU Yu, ZHAO Jin-li, LU Zu-xun. Willingness for first contact care of community and its determinants among residents in Zhuhai City. , 2018, 25(9): 1050-1053.
2018, Vol. 25 
