基于需方的家庭医生签约服务实施效果评价——以慢性病为重点  

The performance evaluation based on the demand side of the family doctor contract service: A focus on chronic diseases

作　　者：芦炜[1] 张宜民[2,3] 梁鸿[2,3] 赵德余[3] 李妍婷 刘姗姗 黄蛟灵[3] 

机构地区：[1]海南师范大学经济与管理学院,海南海口571158 [2]上海市浦东卫生发展研究院,上海200129 [3]复旦大学社会发展与公共政策学院,上海200433

出　　处：《中国卫生政策研究》2016年第8期23-30,共8页Chinese Journal of Health Policy

基　　金：国家自然科学基金(71403171);上海市浦东新区卫生和计划生育委员会学科带头人计划(PWRd2014-13)

摘　　要：目的:了解上海市长宁区家庭医生签约服务的实施对签约居民的影响,分析签约服务的政策效果。方法:对长宁区15岁及以上常住居民进行问卷调查,检验签约与非签约人群在认知、慢性病服务利用和服务评价方面的差异。结果:共有2 886位居民参与研究,其中621人(21.52%)已经签约。签约集中在老年人和慢性病人群,签约组居民在服务认知、评价方面显著高于非签约组,签约的慢性病人群在社区就诊、慢性病管理防治、慢性病医疗费用控制方面均优于非签约的慢性病人群。结论:家庭医生签约服务成效明显,签约有利于引导居民有序就医、控制医疗费用、改善慢性病防治、提高服务评价和依从性,为推动签约服务提供了科学依据。Objective： To understand the impacts of implementation of the Family Doctor Contract Services to community residents contracted to analyze the effects of contracted services policies in Changning,Shanghai. Methods： A questionnaire survey and inspection was conducted among residents over 15 years old,targeted to test the difference in recognition,chronic disease service utilization and healthcare evaluation between residents who have signed a contract and those who have not. Results： There are 2886 residents who participated in the study,a total number of which 621（ say 21. 52%） are already contracted. The contract mostly focused on the elderly and chronic disease patients,who are much higher scored in cognitive evaluation than the non-signatory residents,and are much better in community health service utilization,chronic disease management and chronic medical expenses which are higher for non-contracted crowd. Conclusion： The effect of signing a family doctor is significantly positive. Through contraction,it is well conducted to ordered medical treatment,controlling medical expenses,improving chronic disease management,increasing service evaluation and compliance. And it also provides strong data-based evidence to promote the family doctor contraction service.

关 键 词：家庭医生 签约服务 慢性病 上海长宁区 

分 类 号：R197[医药卫生—卫生事业管理]