“三联合双签约”家庭医师签约服务模式的探索与实践  

Exploration and practice of "3+2" family physician contract service mode

作　　者：朱迪 薛韶文 陈伟国 陈光明 陈跃华 ZHU Di;XUE Shaowen;CHEN Weiguo(Department of General Medicine,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院全科医学科,浙江金华321000 [2]金华市开发区秋滨街道社区卫生服务中心全科医学科 [3]金华市洋埠镇中心卫生院全科医学科

出　　处：《全科医学临床与教育》2025年第3期198-200,共3页Clinical Education of General Practice

基　　金：金华市中心医院基础研究专项科研基金(JY2023-7-05);金华市重大(重点)科学技术研究计划项目(2021-3-055)。

摘　　要：目的 探索浙江省金华市“三联合双签约”家庭医师签约服务模式,以期提供优质的家庭医师签约服务。方法 选取金华市中心医院及金华市秋滨社区卫生服务中心作为试点单位,采用“社区全科—金医全科—金医专科”三联合、“社区全科—金医全科”双签约模式,通过自身前后对照,分析2022~2023年金医全科就诊情况、社区就诊情况、双向转诊情况、联合签约情况、重点人群签约率、签约人数、续约率、两慢病规范管理率等。结果 自2023年1月开始实施“三联合双签约”家庭医师签约服务模式,金医全科与秋滨社区卫生服务中心联合签约家庭3 410户,居民11 353例。通过医院年度诊疗数据报表和信息系统的慢病管理数据,2023年金医全科门诊数量较2022年出现下降(-5.92%),尤以“两慢病”就诊人数下降为主(-8.19%),2023年秋滨社区门诊就诊人数较2022年增加明显(+20.07%),尤其以签约人群社区就诊人数增加明显(+202.37%),重点人群签约率、签约人数、续约率、两慢病规范管理率亦有较大提升。结论 金华市“三联合双签约”家庭医师签约服务模式的实践,能有效保障家庭医师签约服务质量,更有助于分级诊疗制度建设,加快完善分级诊疗体系。Objective To explore the "3+2" family physician contract service model in Jinhua City,so as to provide quality family physician contract service.Methods Jinhua Central Hospital and Jinhua Qiubin Community Health Service Center were selected as pilot units to form a "community general practice-general practice-specialty" three-way combination,"community general practice-general practice" double signing mode,and the general practice visits,community visits,two-way referrals,joint signing conditions from 2022 to 2023 were analyzed.Results From January 2023,the "3+2" family physician contract service model was implemented,and 3410 families and 11353 residents were jointly signed by the general practice and Qiubin Community Health Service Center.According to the annual diagnosis and treatment data report of the hospital and chronic disease management data of the information system,the number of outpatient departments of general medicine in 2023 decreased(-5.92%)compared with 2022,especially the number of patients with "two chronic diseases" decreased(-8.19%),and the number of outpatient departments in Qiubin community in2023 increased significantly compared with 2022(+20.07%).In particular,the number of patients in the community increased significantly(+202.37%).Conclusion The practice of "3+2" family physician contract service mode in Jinhua city can effectively guarantee the quality of family physician contract service,and it is more conducive to the construction of hierarchical diagnosis and treatment system and accelerate the improvement of hierarchical diagnosis and treatment system,which is worth learning and promoting.

关 键 词：全科医师 社区居民 联合签约 专科医师 

分 类 号：F42[经济管理—产业经济]