某市家庭医生服务签约居民的就诊体验研究  

Study on patient experiences of residents contracted with family doctor services in a city

作　　者：柳松艺 孟文奇 彭海波 姜晓利 李子鑫 于倩倩[1] 尹文强[1] 陈钟鸣[1] 孙葵[1] 郭洪伟[1] Songyi Liu;Wenqi Meng;Haibo Peng;Xiaoli Jiang;Zixin Li;Qianqian Yu;Wenqiang Yin;Zhongming Chen;Kui Sun;Hongwei Guo(School of Management,Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院管理学院,261053

出　　处：《中华医院管理杂志》2021年第9期766-771,共6页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(71804130)。

摘　　要：目的评价和分析签约居民在基层医疗机构的就医体验, 为进一步改善家庭医生签约服务质量提供依据。方法利用汉化版的基本医疗质量评估量表(primary care assessment tools, PCAT), 于2020年5—6月对某市9所社区卫生服务中心和9所乡镇卫生院的1 400名家庭医生服务签约居民进行入户调查, 分析其在基层医疗机构的就诊体验。同时对机构管理人员及家庭医生团队进行访谈。运用描述性统计与单因素方差分析进行数据分析。结果共回收有效问卷1 333份, 有效回收率为95.2%。PCAT量表总得分25.17分, 其中首诊、连续性、协调性、综合性、以患者和家庭为中心、社区为导向及文化胜任力7个维度的得分依次为3.57分、3.68分、3.54分、3.40分、3.72分、3.67分和3.59分;372人(47.1%)在去上级医院或专科医院之前未经过签约机构转诊;不同机构类型、年龄、学历、职业和收入的居民在首诊、连续性、协调性与综合性4个核心维度的评分差异有统计学意义(P<0.001)。结论该市家庭医生签约服务工作取得了一定成效, 但仍有提升空间, 建议进一步完善服务的综合性、协调性和可及性, 推动家庭医生签约服务的高质量发展。Objective To evaluate and analyze the patient experience of residents contracted with primary medical institutions,for providing a basis for improving quality of contracted family doctor services.Methods Using the Chinese version of the primary care assessment tools(PCAT),a household survey was conducted on 1400 contracted residents in 9 community health service centers and 9 township health centers in a city from May to June 2020,and their medical experience in primary medical institutions was statistically analyzed.At the same time,interviews were conducted with institutional managers and family doctors.Descriptive statistics and one-way ANOVA were used for data analysis.Results 1333 valid questionnaires were collected,and the effective recovery rate was 95.2%.The total PCAT scoring was 25.17.Seven dimensions of first contact,continuous,coordination,comprehensiveness,patient and family centered,community-oriented and cultural competence scored in average 3.57,3.68,3.54,3.40,3.72,3.67 and 3.59 respectively.372 people(47.1%)had not been referred by the contracted institution before going to the superior hospital or specialized hospital.There were significant differences in the scores of four core dimensions in different types of institutions,age,education level,occupation and income(P<0.001).Conclusions Given the initial progress of contracted family doctor services in the city,there is still room for improvement.It is suggested to further improve the comprehensiveness,coordinationand accessibility of services,and promote the high-quality development of contracted family doctor services.

关 键 词：家庭医疗保健服务 家庭医生 就诊体验 基本医疗质量评估量表 居民 

分 类 号：R197.1[医药卫生—卫生事业管理]