供需双方对家庭医生签约服务评价研究
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摘要
目的了解浦口区家庭医生签约服务的现状与存在的问题,以及供需双方对家庭医生总体服务、家庭医生首诊服务以及家庭医生与上级医院的协同效果,为家庭医生签约制度的深入推进提供依据。方法对2015年以来与家庭医生签约的居民1179人和家庭医生团队的医务人员287人进行问卷调查。结果供需双方对家庭医生签约服务的评价呈现差异化;重点人群对家庭医生签约服务评价较高;不同文化程度的居民对不同类型服务的评价呈反向结果;制约家庭医生首诊效果的主要因素是政策宣传力度不够、政策引导和约束不够、家庭医生服务能力不足、家庭医生制度目的不明;制约家庭医生与上级医院协同效果的主要因素有转诊渠道不畅通、预约资源受限。结论提高医务人员的收入、关注非重点人群、提升医务人员服务能力、完善家庭医生签约服务相关政策和规范转诊流程有利于进一步推进浦口区家庭医生的签约服务。
Objective To know about the status quo of family doctors' contract health care services in Pukou District of Nanjing and the existing problems,to evaluate the overall services of family doctors,the first consultation service of family doctors,and the synergy effect between family doctors and hospitals at higher level from the perspective of the supply and demand,so as to provide references for the promotion of the family doctors contract system. Methods A questionnaire survey was conducted on 1179 residents who signed the family doctors since2015 and 287 medical staff members who were in the family doctors team. Results The evaluation of family doctors contract services was different between the parties of supply and demand. The key populations had higher evaluation for family doctors contract services. The residents with different educational backgrounds had inverse results in evaluating different types of services. The main constraints affecting the results of the first visit of family doctors were inadequate policy publicity,insufficient policy guidance and discipline,insufficient capability of family doctors,and unclear purpose of family doctor system. The main constraints of the synergy effect between family doctors and higher-level hospitals were unsmooth referral channels and limited reservation resources. Conclusions It is important for promoting the contract service for family doctors in Pukou District of Nanjing to improve the income of medical staffs,attach importance to the non-key population,improve the capability of medical staffs,improve the policy-making related to family doctors contract services,and standardize the referral process.
Objective To know about the status quo of family doctors' contract health care services in Pukou District of Nanjing and the existing problems,to evaluate the overall services of family doctors,the first consultation service of family doctors,and the synergy effect between family doctors and hospitals at higher level from the perspective of the supply and demand,so as to provide references for the promotion of the family doctors contract system. Methods A questionnaire survey was conducted on 1179 residents who signed the family doctors since2015 and 287 medical staff members who were in the family doctors team. Results The evaluation of family doctors contract services was different between the parties of supply and demand. The key populations had higher evaluation for family doctors contract services. The residents with different educational backgrounds had inverse results in evaluating different types of services. The main constraints affecting the results of the first visit of family doctors were inadequate policy publicity,insufficient policy guidance and discipline,insufficient capability of family doctors,and unclear purpose of family doctor system. The main constraints of the synergy effect between family doctors and higher-level hospitals were unsmooth referral channels and limited reservation resources. Conclusions It is important for promoting the contract service for family doctors in Pukou District of Nanjing to improve the income of medical staffs,attach importance to the non-key population,improve the capability of medical staffs,improve the policy-making related to family doctors contract services,and standardize the referral process.
引文
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[5]邱宝华,黄蛟灵,梁鸿,等.家庭医生签约服务利用与满意度的比较研究[J].中国卫生政策研究,2016,9(8):31-36.
[6]魏敏.患者选择医院的影响因素分析[D].合肥:安徽医科大学,2014.
[7]杜丽君,林伟良.社区家庭医生制度政策保障存在问题及对策分析[J].中国农村卫生事业管理,2013,33(8):876-878.
[8]郭晓玲,吴浩,刘新颖,等.智慧家庭医生优化协同模式的构建与实现[J].中国全科医学,2017,20(7):784-788.
[9]赵光斌,杜光会,林敏.制约双向转诊制度实施因素研究[J].中国全科医学,2013,16(25):2930-2932.
[10]梅玲明,陈翔,杨冬仙,等.县-社区医疗联动规范转诊管理的实践[J].中国全科医学,2014(36):4378-4380.
[2]熊婷,陈家应,胡丹,等.南京市浦口区家庭医生签约服务开展现况调研[J].中国全科医学:2018,21(33):28-32.
[3]刘春平,陈添华,李巧,等.海南省家庭医生服务现状和职业满意度调查研究[J].经济研究导刊,2017,(12):95-96,102.
[4]戴华仁,黄蛟灵,储一鸣,等.家庭医生签约服务供需双方的满意度比较研究[J].中国初级卫生保健,2019(1):24-26.
[5]邱宝华,黄蛟灵,梁鸿,等.家庭医生签约服务利用与满意度的比较研究[J].中国卫生政策研究,2016,9(8):31-36.
[6]魏敏.患者选择医院的影响因素分析[D].合肥:安徽医科大学,2014.
[7]杜丽君,林伟良.社区家庭医生制度政策保障存在问题及对策分析[J].中国农村卫生事业管理,2013,33(8):876-878.
[8]郭晓玲,吴浩,刘新颖,等.智慧家庭医生优化协同模式的构建与实现[J].中国全科医学,2017,20(7):784-788.
[9]赵光斌,杜光会,林敏.制约双向转诊制度实施因素研究[J].中国全科医学,2013,16(25):2930-2932.
[10]梅玲明,陈翔,杨冬仙,等.县-社区医疗联动规范转诊管理的实践[J].中国全科医学,2014(36):4378-4380.