以家庭医生为核心的社区卫生服务模式的构建与成效分析

在上海市新一轮社区综合改革背景下，马陆镇社区卫生服务中心通过竞聘重组家庭医生团队，建立家庭医生工作形式，明确家庭医生团队服务内容，开展家庭医生工作室建设，建立家庭医生团队为核心的内部管理机制等举措，构建以家庭医生为核心的社区卫生服务模式。从运行效果来看，模式构建后，常住人口及慢性病患者人群签约率、社区就诊率上升，基本医疗质量指标、基本公共卫生服务质量指标明显改善，社会评价指标、全科医生人力资源指标有所改善，科研能力有所提升。以家庭医生为核心的社区卫生服务模式的构建，对充分发挥家庭医生健康与费用“守门人”作用，建立有序就医格局，促进居民健康具有重要意义。

Development and Effectiveness Analysis of a Community-based Family Doctor-centered Care Delivery Model

During the implementation of a new round of comprehensive reform of community-based care system in Shanghai，Malu Community Health Service Center（MCHSC） rebuilt a family doctor team consisting of members recruited competitively，with defined service content and family doctor-centered internal management mechanism，offering services in a community-based family doctor-centered care delivery model via specific ways of working based on the conditions of the service area（including working in the family doctors' studio constructed specially）.Since this care delivery model was put into practice，MCHSC has achieved significantly increased rate of resident population and chronic disease patients signing a contract with the family doctor team，obviously enhanced rate of visiting，substantially improved basic public health service quality indicators，social indicators for evaluating the performance of family doctors，allocation status of general practitioners and research capabilities.The community-based family doctor-centered care delivery model is of vital significance in giving full play to the role of the family doctor as a gatekeeper contributing to primary care quality assurance and healthcare cost control，advancing healthcare seeking in a hierarchical manner and promoting residents' health.