供方视角下家庭医生签约服务的执行优化路径分析  

Analysis on the implementation optimization path of family physician contract service from the perspective of supplier

作　　者：李子鑫 柳松艺 李战胜 孟文奇 尹文强[1] 孙葵[1] 陈钟鸣[1] 于倩倩[1] 王小燕 张元力 Li Zixin;Liu Songyi;Li Zhansheng;Meng Wenqi;Yin Wenqiang;Sun Kui;Chen Zhongming;Yu Qianqian;Wang Xiaoyan;Zhang Yuanli(School of Management,Weifang Medical University,Weifang 261053,China;Health Commission of Weifang,Weifang 261061,China;Hanmiao Township Hospital,Shanghe County,Jinan 251618,China;Ganggou Street Office Community Health Service Center,Licheng District,Jinan 250102,China)

机构地区：[1]潍坊医学院管理学院,山东省潍坊市261053 [2]潍坊市卫生健康委员会,山东省潍坊市261061 [3]济南市商河县韩庙镇卫生院,251618 [4]济南市历城区港沟街道办事处社区卫生服务中心,250102

出　　处：《中华医院管理杂志》2021年第4期336-341,共6页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(71804130)。

摘　　要：目的通过分析家庭医生对签约服务的认知和服务意愿,探讨在供方视角下推行家庭医生签约服务的执行障碍及可行性策略。方法2020年7—10月,采用问卷调查法与关键人物访谈法对山东省3个地市中各县、市或区的社区卫生服务中心或乡镇卫生院的850名家庭医生进行现场问卷调查。运用描述性分析、二分类logistic回归模型,对家庭医生提供签约服务的意愿进行统计学分析;通过问卷调查与关键人物访谈法相结合,探讨家庭医生视角下签约服务的执行障碍因素及服务优化策略。结果获得有效问卷791份,其中688人(87.0%)表示认可家庭医生签约服务的开展,679人(85.8%)表示愿意提供家庭医生签约服务。婚姻状况、服务政策认可度、服务运行效果满意度、服务发展前景乐观度、居民患病首选度是影响家庭医生服务意愿的因素。结论应通过丰富政策配套措施、创新应用"互联网+"、加大人才培养力度、优化绩效考核工作及营造有利舆论环境等策略有效提高家庭医生服务意愿,推动家庭医生签约服务政策的高效有序执行。Objective To analyze the cognition and willingness of family physicians on contracted service,and to explore the implementation obstacles and feasible strategies of implementing contracted service of family physicians from the perspective of suppliers.Methods From July to October 2020,850 family physicians in community health service centers or township health centers in three cities of Shandong Province were investigated by questionnaire survey and key person interview.Descriptive analysis and binary logistic regression model were used to analyze the willingness of family physicians to provide contracted service.Through questionnaire survey and key person interview,the implementation obstacles and service optimization strategies of family physicians were discussed.Results 791 valid questionnaires were obtained,of which 688(87.0%)approved the implementation of family physician contract service,and 679(85.8%)expressed willingness to provide family physician contract service.Marital status,recognition of service policy,satisfaction of service operation effect,optimistic degree of service development prospect and residents′first choice of illness were the factors influencing family physician′s service willingness.Conclusions We should effectively improve the family doctor′s service intention and promote the efficient and orderly implementation of family doctor′s contract service policy through enriching policy supporting measures,innovating the application of"Internet plus",increasing personnel training,optimizing performance appraisal work and creating favorable public opinion environment.

关 键 词：医生 家庭 签约服务 认知 意愿 问卷调查 

分 类 号：R197.1[医药卫生—卫生事业管理]