江苏省家庭医生签约服务的现状及对策  

Current status and strategy research of family doctor contracted service in Jiangsu Province

作　　者：王冬阳[1] 陆雅文 王梦圆[1] 黄晓光[1] WANG Dongyang;LU Yawen;WANG Mengyuan;HUANG Xiaoguang(School of Health Policy and Management,Nanjing Medical University,Nanjing 211166,Jiangsu China)

机构地区：[1]南京医科大学医政学院,南京211166

出　　处：《中国卫生资源》2018年第2期140-143,148,共5页Chinese Health Resources

摘　　要：目的了解江苏省家庭医生签约服务推行现状,为推进家庭医生签约服务提供对策建议。方法在江苏省13市进行抽样调查,每市抽取8个已实施家庭医生签约服务的基层医疗卫生机构填写问卷调查表,主要内容包括居民签约情况、签约服务模式、家庭医生团队组建情况、家庭医生参与情况、机构促进签约措施、机构实施签约服务遇到的问题及建议6个方面。结果 69.7%的机构已签约总人口数/服务辖区常住人口数在30%以下,50.5%的机构已签约重点人口数/已签约总人口数在50%以上。54.5%的机构以团队为签约服务主体,85.9%的机构提供签约服务包。50.5%的机构更加注重保证已签约居民服务质量和满意度,81.8%主要签约重点人群。49.5%的机构有基本公共卫生经费支持。49.2%的社区卫生服务中心组建了6~10个签约服务团队,60.0%的乡镇卫生院组建了0~5个签约服务团队。65.7%的机构采取机构指派医生参与的方式,98.0%的机构家庭医生为非专职,同时兼职其他服务。大部分机构都采取"提供健康咨询与健康教育""部分检查项目免费或优惠""提供个性化的健康管理"三项措施,城乡机构在"提供健康咨询与健康教育"(χ2=7.24,P=0.01)和"试点阶段免费签约"(χ2=4.39,P=0.04)两方面存在差异。82.8%的机构建立了相应的津贴和奖金。82家机构认为"签约服务工作量大,人员短缺"。结论建议要及时总结,稳步推进家庭医生签约服务;加强人才培养,合理配置签约服务团队人员;完善激励机制,调动家庭医生积极性;持续落实促进措施,提高居民认知。Objective To understand the present situation of family doctor contracted service in Jiangsu Province,to provide relevant policy suggestions for further promoting the family doctor contracted service.Methods A sample survey was conducted in thirteen cities of Jiangsu Province.In each city,eight primary medical institutions that had implemented contracted service were selected to complete the questionnaire.The investigation mainly includes the following six aspects:contracted situation of citizens,mode of contracted service,team formation of family doctor,participation situation of family doctor,promotion measures taken by institution,problems and suggestions for the implementation of contracted service.Results A total of 69.7%of the institutions had a rate of the total contracted population/permanent population in service area that was below 30%,50.5%of the institutions had a rate of the contracted key population/total contracted population that was above 50%,54.5%of the institutions made the family doctor team as the main body of contracted service,85.9%of the institutions offered contracted service packs,50.5%of the institutions paid more attention to ensuring the quality of service and satisfaction of contracted residents,81.8%of the institutions mainly contracted with the key groups,49.5%of the institutions were subsidized by basic public health funding,49.2%of the community health care centers had set up 6-10 contracted service teams,60.0%of township health centers had set up 0-5 contracted service teams,65.7%of the institutions took the form of family doctors being appointed by organizations,and 98.0%of the institutions took the form of family doctors being part-time workers and undertook other services at the same time.Most of the institutions provided the following three services:“health counseling and education”,“free or preferential price for some inspection projects”and“personalized health management”.Difference existed in urban and rural institutions with respect to“health counseling and

关 键 词：家庭医生 签约服务 现状 对策 

分 类 号：R197.1[医药卫生—卫生事业管理]