基于SERVQUAL量表的农村家庭医生团队模式服务质量评价

目的 运用SERVQUAL量表对贵州省大方县长石镇以村医为基础的家庭医生团队服务质量进行评价，为提高农村家庭医生服务质量提供参考。方法 根据SERVQUAL量表设计问卷，对长石镇由家庭医生团队开展签约服务的试点村和仅由村医开展签约服务的非试点村居民进行调查，通过对比研究评价家庭医生团队服务的实施效果。结果 医疗服务质量评价总得分试点村（-0.95）高于非试点村（-2.26），有形性、可靠性、响应性、保证性、移情性5个维度得分试点村（分别为-0.87、-1.15、-1.05、-0.70、-0.98）均高于非试点村（分别为-1.22、-2.54、-2.85、-2.14、-2.57），差异均有统计学意义（P<0.05）。试点村5个维度中可靠性得分最低（-1.15），单项上家庭医生治疗费用低廉、诊疗准确有效得分最低（-1.52）。此外，78%的调查对象认为卫生院和卫生室药品种类不全、数量少。结论 农村地区开展家庭医生团队服务能提高医疗服务质量，但也存在不足，应进一步降低收费、提高诊疗水平、增加基层医疗机构药品种类和数量，以提高医疗服务质量。

Assessmentof service quality of family doctor service modelin rural areas based on SERVQUAL

Objective To evaluate the medical service quality of family doctor in Changshi town based on Service Quality scale to provide references for carrying out the family doctor service in rural areas. Methods The questionnaire designed according to SERVQUALscalewas investigated in experimental areas and non-experimental areas in Changshi, where the family doctor service have been carried out. The implement effect was evaluated by a comparative research in rural areas. Results Medical service quality estimation total scores in experimental areas and non-experimental areas were -0.95 and -2.26 respectively. The visibility, reliability,responsiveness, guarantee and empathetic five dimensions were -0.87, -1.15, -1.05, -0.70, -0.98 in experimental areas respectively and -1.22, -2.54, -2.85, -2.14, -2.57 in non-experimental areas respectively. Therewas significantly statistical difference (P<0.05, respectively). The reliability, the cost and diagnosis was -1.15 and -1.52 respectively, which was the lowest in five attributes and in single items of experimental areas.In addition, 78%of the residentsconsidered that the variety and quantityofmedicinewere insufficient in healthcenters and health rooms. Conclusion The family doctor service in rural areas can improve thesatisfaction of medical services, but reducing and transparent charging, improving clinic level, and increasing types and quantity of drug of grassrootmedical institutions could be reinforced.