基于卡诺模型的功能楼宇人群家庭医生签约服务需求特征研究

BackgroundWith the continuous deepening of the family doctor contract service systemhow to effectively cover the functional building population with family doctor contract services has become one of the focuses of attention. Effectively understanding the demand characteristics of this group of people is an important means to establish effective strategies. ObjectiveTo understand the demand for family doctor contract services among functional building populationsand provide reference for improving and optimizing family doctor contract services in functional buildings. MethodsIn March April 2024a typical sampling method was used to select 3 functional buildings in the jurisdiction of the research groupand a cluster random sampling method was used to select 396 middle-aged and young people from functional communities for a questionnaire survey. The questionnaire includes general demographic informationKANO questionnaire on the demand for family doctor contract servicesthe time period of receiving the most family doctor contract services in the past 6 monthsand willingness to pay. Conduct reliability and validity analysis of the KANO questionnaire on the demand for family doctor contract servicesconstruct a Better Worse matrix to analyze the KANO demand characteristics of 19 service itemsand conduct sensitivity analysis based on different service periods and payment intentions. ResultsA total of 396 valid survey questionnaires were collectedand the Cronbach  of the scale formed by 19 signed service items was 0.991. According to the KANO modela preliminary classification of the items showed that 19 items belonged to the category of undifferentiated attributes. A better worse matrix was constructed to further divide the demand attributes. In the diagnosis and treatment service2 items were classifiedincluding "medication dispensing service" and "expert consultation service". In the health management service9 itemsincluding "interpretation of physical examination reports and health consultation""prevention and treatment of eye diseases"and "prevention and treatment of cervical spondylosis"belonged to the category of "expected attributes". In the diagnosis and treatment servicethe "extended prescription" service belonged to the category of attractive attributeswhile the rest belonged to the category of undifferentiated attributes. Sensitivity analysis shows that the "long prescription" service has the highest SR value one hour before work and on weekends. The service of "TCM constitution identification/massage/moxibustion/cupping/scraping/acupuncture and moxibustion" has the highest SR value in one hour at noon. The SR value of "expert consultation" services is highest when the willingness to pay is between 0-50 yuan/person/year and 201 yuan/person/year. The SR value of "TCM constitution identification/massage/moxibustion/cupping/scraping/acupuncture and moxibustion" service is the highest when the willingness to pay is 151~200 yuan/person/year. ConclutionThe functional building population has high expectations for specialized health management services under the contract of family doctorsand the demand content is diversified. At the same timethe contracted diagnosis and treatment services provided by family doctorssuch as long prescriptionsdrug dispensingand expert consultationsare the cornerstone of meeting the service needs of middle-aged and young people. Further optimization and improvement of service content design for this type of population should be carried out.