医保主导的家庭医生签约服务试点效果分析——基于M市“两病”患者监测数据  

Analysis of the Pilot Effectiveness of Family Doctor Contracted Service Led by Medical Insurance--Based on the Monitoring Data of Patients with"Two Diseases"in M City

作　　者：李悦 邓世虎 张进 孙宇 陈爱中 邹娟 彭美华[1] LI Yue;DENG Shihu;ZHANG Jin;SUN Yu;CHEN Aizhong;ZOU Juan;PENG Meihua(School of Management,Chengdu University of Traditional Chinese Medicine,Chengdu Sichuan 610075,China;不详)

机构地区：[1]成都中医药大学管理学院,四川成都610075 [2]眉山市医疗保障局,四川眉山620010 [3]眉山市青神县医疗保障局,四川眉山620400 [4]眉山市青神县卫生健康局,四川眉山620400 [5]眉山市青神县医院集团,四川眉山620400

出　　处：《卫生经济研究》2025年第4期33-36,41,共5页

基　　金：成都中医药大学杏林学者项目“乡村振兴战略背景下紧密型县域医共体建设:成效、困境与对策研究”(XCZX2022017);省哲学社科基地四川中医药大健康产业发展与乡村振兴研究中心重点项目“支持中医药传承创新发展的医保DRG支付政策优化研究”(DJKZD202301)。

摘　　要：目的:分析M市医保主导的家庭医生签约糖尿病、高血压(“两病”)患者的试点成效,提出政策建议。方法:采用描述性统计方法,对比分析M市改革县与非改革县家庭医生签约服务改革成效。结果:相比非改革县,改革县“两病”患者对基层医疗卫生机构与家庭医生的信任度和满意度显著提高,健康素养和自评健康状况得到改善。结论:医保主导的家庭医生签约服务改革初显成效,但需进一步深化,提高政策协同性与基层“两病”管理能力,优化绩效考核制度,加强信息化建设,扩大政策惠及面。Objective To analyze the pilot effectiveness of family doctors signing contracts with patients with diabetes and hypertension("two diseases")led by medical insurance in M city,and to make policy recommendations.Methods Descriptive statistics were used to compare and analyze the effectiveness of family doctor contracted service reform in reform counties and non-reform counties in M city.Results Compared with the non-reform counties,patients with"two diseases"in the reform counties showed significantly higher trust and satisfaction in primary healthcare institutions and family doctors,and improved health literacy and self-assessed health status.Conclusion The reform of family doctor contracted service led by medical insurance has begun to show results,but it needs to be further deepened.It is necessary to improve the synergy of policies and the ability of primary healthcare institutions to manage"two diseases",optimize the performance appraisal system,strengthen the construction of informatization,and broaden the benefit of the policy.

关 键 词：慢病管理 家庭医生签约服务 糖尿病 高血压 

分 类 号：R19[医药卫生—卫生事业管理]