兰州市家庭医生签约服务开展现状研究  

Study on Current State of the Signing Service of Family Doctors in Lanzhou City

作　　者：白润娟 陈佳琦 张晓岚[2] 李芳 张德娟[2] BAI Runjuan;CHEN Jiaqi;ZHANG Xiaolan;LI Fang;ZHANG Dejuan(Nursing School,Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of Traditional Chinese Medicine)

机构地区：[1]甘肃中医药大学护理学院,甘肃兰州730000 [2]甘肃省中医院

出　　处：《西部中医药》2021年第3期101-104,共4页Western Journal of Traditional Chinese Medicine

基　　金：甘肃省卫生健康委员会社区项目。

摘　　要：目的:了解兰州市家庭医生签约服务现状。方法:于2019年8~10月采用典型调查法,选取兰州市6个社区卫生服务中心,27个社区卫生服务站作为调研地,根据地区特点结合文献编制《兰州市家庭医生签约服务——社区居民调查问卷》《兰州市家庭医生签约服务——社区医护人员调查问卷》进行问卷调查。结果:812名居民中已签约502名(61.8%),未签约310名(38.2%);居民未签约家庭医生的主要原因是家庭医生技术不高及服务效果不好占32.9%(102/310);家庭医生团队中全科医生占12.1%(21/174);知道转诊上级医院流程者占32.5%(163/502);居民了解家庭医生签约途径主要是经社区卫生服务人员介绍占73.0%(479/656);家庭医生推行困难的原因主要是居民就医观念不正确,对家庭医生的需求和期望不切实际占52.8%(112/212),其次是配套政策不完善(医保、支付方式等政策)占42.0%(89/212)。结论:需要强化家庭医生团队综合实力,提高居民对家庭医生的信任度;加大宣传力度,彻底贯彻和落实家庭医生签约服务相关政策;推进社区信息化建设,提高工作效率;针对不同人群设计个性化签约服务包,定制多样化签约服务内容。Objective:To investigate current state of the signing service of family doctors in Lanzhou city.Methods:Using typical investigation method,six community health centres and 27 community health service stations were chosen as the research sites from August to October,2019,and conduct a questionnaire survey,the questionnaire was contracting service of family doctors in Lanzhou city:questionnaire of community residents and contracting service of family doctors in Lanzhou city:questionnaire of community doctor and nurse,organized according to regional characteristics and document.Results:Among 812 residents,502 residents had signed up(61.8%),310 didn’t sign the contract(38.2%),the main reasons for residents not signing the contract were that family doctors are not skilled,the service effects are not good 32.9%(102/310),among the family doctors,general practitioners held 12.1%(21/174),the doctors who know the process of referral to superior hospitals occupied 32.5%(163/502);73.0%(479/656)of the residents knew that the main way to sign the contract was through the introduction of community health service personnel;The main reason for the difficulty in implementing family doctors was that the residents,concept of seeking medical treatment was incorrect,and the unrealistic demand and expectation for family doctors was 52.8%(112/212),followed by the imperfect supporting policies(medical insurance,payment methods and other policies),which was 42.0%(89/212).Conclusion:It is necessary to strengthen the comprehensive strength of the family doctor team and increase the trust of residents in family doctors;increase publicity,thoroughly implement relevant policies for family doctor contract services;promote community information construction and improve work efficiency;design personalized contract service package for different groups,and customize diversified contract service content.

关 键 词：兰州市 家庭医生签约服务 现状调查 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]