“村医社医联动”签约模式在京北山区老年居民中的应用效果及对策研究  

Application Effect and Countermeasures of the Family Contract Service Model Based on"the Consortium of Rural Doctors and Community Doctors"Among the Elderly Residents in the Mountainous Area of North Beijing

作　　者：张如意[1] 彭迎春[1] 张志颖 ZHANG Ruyi;PENG Yingchun;ZHANG Zhiying(School of Medical Humanities,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学医学人文学院,北京市100069

出　　处：《中国全科医学》2022年第4期445-452,共8页Chinese General Practice

基　　金：北京市社会科学基金项目(19JDSRB008);北京市教育委员会社科计划一般项目(SM202010025006);首都卫生发展科研专项培育项目(首发-2018-3P-7141)。

摘　　要：背景京北山区的老年居民慢性病高发、经济基础薄弱、获取健康知识的途径有限、距离社区卫生服务机构路途较远。目前京北山区家庭医生团队由社区医生和乡村医生共同组成,二者在山区老年居民签约服务中共同发挥重要作用。目的了解京北山区老年居民家庭医生签约服务开展现状,并对山区老年居民家庭医生签约服务模式提出适宜建议。方法采用定性研究和定量研究相结合的方法。2019年9—10月,选取北京市怀柔区北部山区的8个乡(镇),按比例抽取每个乡(镇)家庭医生团队的社区医生、乡村医生及签约老年居民进行问卷调查,共计抽取社区医生141例、乡村医生133例、老年居民345例。老年居民问卷内容包含基本情况、希望家庭医生团队提供服务的方式及内容、认为获取健康资讯最有效的渠道、对该服务模式的满意度等;乡村医生和社区医生问卷内容包含基本情况、开展签约服务中互联网使用情况、为老年居民提供的服务内容等。同期,采用目的抽样法选取24例社区医生、24例乡村医生、16例老年居民进行个人深度访谈,了解调研对象对联动签约服务模式中乡村医生和社区医生职责的认知、对该签约服务模式的看法、对互联网在该模式中应用的看法、对该签约模式发展的建议等,采用内容分析法对定性资料进行分析。结果量性研究结果显示,京北山区老年居民希望家庭医生团队提供的签约服务内容前3位依次为下乡开展大课堂宣传〔199(57.7%)〕、下乡体检〔197(57.1%)〕、送医送药下乡巡诊〔169(49.0%)〕;老年居民希望家庭医生团队开展服务的方式或渠道前3位依次为门诊诊疗服务,上门医疗服务、在社区组织健康宣教讲座;老年居民认为获取健康资讯最有效的前3种渠道依次是乡村医生/村中喇叭宣传〔253(73.33%)〕、社区医生就诊时面对面宣传〔134(38.84%)〕�Background The elderly residents in the mountainous area of northern Beijing have a high incidence of chronic diseases,a weak economic foundation,limited access to health knowledge,and a long distance from community health service institutions.At present,the team of family doctors in the mountainous area of northern Beijing is composed of community doctors and rural doctors.Both of them play an important role in contracting services for elderly residents in mountainous areas.Objective To explore the current status of family doctor contracted services in the northern mountain areas of Beijing and put forward appropriate suggestions on family doctor contracted services with the elderly residents in mountain areas.Methods A combination of qualitative research and quantitative research was adopted.From September to October 2019,eight townships were selected in the northern mountain areas of Huairou District in Beijing.A total of 141 community doctors,133 rural doctors and 345 elderly residents were selected proportionally from each township for questionnaire research.The elderly resident's questionnaires included basic information of the elderly,the way and the content of services which they want family doctor team to provide,the channels to obtain health consultation,and the satisfaction evaluation of the contracted services;the rural doctors and the community doctors'questionnaires included basic information,the use of internet in the contracted services,and the content of services provided to the elderly residents.During the same period,16 cases of elderly residents,24 cases of community doctors,and 24 cases of rural doctors were selected by using the purposive sampling method for personal in-depth interviews,in order to understand the level of awareness of the responsibilities of community doctors and rural doctors in the linkage contracted services,their views on the contracted services and the application of the internet in this service model,their suggestions on the development of the contracted services,etc.A

关 键 词：家庭医生签约服务 老年人保健服务 山区 社区卫生服务 北京 

分 类 号：R197[医药卫生—卫生事业管理]