家庭医生签约服务背景下京郊山区医养结合服务现状及对策探析  

Analysis on the present situation and countermeasures of combined medical and nursing servicesin Beijing suburb mountainous areas under the background of family doctor contract service

作　　者：陈静静 王海利 裴若童 杨凯文 彭迎春[3] CHEN Jingjing;WANG Haili;PEI Ruotong;YANG Kaiwen;PENG Yingchun(Beijing Huairou District Liulimiao Town Community Health Service Center,Beijing 101409,China;不详)

机构地区：[1]北京市怀柔区琉璃庙镇社区卫生服务中心,北京101409 [2]首都医科大学公共卫生学院,北京100069 [3]首都医科大学医学人文学院,北京100069

出　　处：《中华全科医学》2025年第5期806-809,852,共5页Chinese Journal of General Practice

基　　金：北京市怀柔区卫生健康委员会2022年科研项目(2022-C-002);北京市怀柔区卫生健康委员会2023年科研项目(2023-A-01);北京市社会科学基金项目(22SRB008)。

摘　　要：目的 了解京郊山区医养结合服务现状,从家庭医生签约服务团队提供服务和老年居民及其照护者服务需求2个层面分析现存问题并提出改进对策。方法 对北京市怀柔区北部山区5个乡镇133名已经签约家庭医生的65岁以上老年居民进行问卷调查,了解目前养老方式和就医情况及其养老、就医服务需求;同时对5家社区卫生服务中心家庭医生签约服务团队医务人员进行问卷调查,了解医养结合服务提供情况。结果 接受调查的133名老年居民中,128名(96.2%)选择居家、社区养老,102名(76.7%)主要和配偶互相照护;75.2%(100/133)的老年居民出现健康问题后直接前往乡镇卫生院或村卫生室就诊,12.0%(16/133)的老年居民首先电话咨询家庭医生,根据家医指导后就医。在服务需求方面,有43位(32.3%)提出了上门医疗服务需求,41位(30.8%)提出了经济支持需求。在服务提供方面,位于前三位的是老年人健康管理服务、门诊服务和上门健康评估。结论 居家养老是京郊山区老年人主要的选择,社区卫生服务机构和家庭医生是其医养结合服务的主要提供者。目前供需之间仍然存在差距,保障机制也不够完善。建议在落实家庭医生签约服务的基础上,进一步探讨家庭医生在社区居家养老中服务整合及资源协调的作用,全面提升医养结合服务的质量和效率。Objective To understand the current situation regarding healthcare integration services in mountainous areas in the suburbs of Beijing,it is necessary to firstly analyze the existing problems and propose countermeasures in terms of the services provided by the contracted family doctor service teams and the services demands of elderly residents and their caregivers.Methods A questionnaire survey was conducted on 133 elderly people over the age of 65,who had signed a contract in five townships and towns in the northern mountainous area of Huairou District,Beijing.Concurrently,a questionnaire survey was conducted on the medical staff of the family doctor contracted service teams of the five community health service centers to understand the situation of the provision of integrated medical care and nursing care services.Results Among the 133 elderly residents who took part in the survey,128(96.2%)said they wanted to continue living at home and in the community,and 102(76.7%)said they mainly took care of each other with their husbands or wives;75.2%(100/133)of the elderly residents went to the township health center or the village health center directly when they had a health problem,and 12.0%(16/133)of them first called their family doctor;12.0%(16/133)of elderly residents first call their family doctors for advice and then seek medical treatment.In terms of service needs,43 individuals(32.3%)expressed a demand for home-based medical services,while 41(30.8%)requested financial support.Regarding service provision,the top three services offered were health management for the elderly,outpatient services,and in-home health assessments.Conclusion Home-based elderly care is the primary choice for older adults in mountainous suburban areas of Beijing,with community health service institutions and family doctors serving as the main providers of integrated medical and elderly care services.However,there remains a gap between service supply and demand,and the supporting mechanisms are still inadequate.It is recommended that,on

关 键 词：家庭医生签约服务 居家社区养老服务模式 医养结合服务 

分 类 号：R197.61[医药卫生—卫生事业管理] R499[医药卫生—公共卫生与预防医学]