京郊山区家庭医生签约服务区级与内部考核结果的差异分析

目的 了解京郊山区社区卫生服务机构家庭医生签约服务上级考核与内部考核结果的差异,分析存在的原因并提出解决对策。 方法 收集2018年1-4月期间京郊山区某社区卫生服务中心家庭医生签约服务考核资料,包括区级对机构的考核和机构内部的考核两个层面的资料。机构内部考核人员经统一培训后负责开展内部考核;上级主管部门同时期对该机构进行相同项目的考核。各级考核人员均通过信息系统核查了解机构工作数量完成情况;采用电话访谈法了解签约居民对服务的认知情况,并作为对机构开展家医签约工作真实性的判断依据;对家庭医生签约服务及高血压、糖尿病患者健康管理工作进行质量考核。根据上述结果,对机构工作的真实性和有效性进行综合分析,判断工作开展情况。对比分析机构内部考核和上级主管部门考核结果之间存在的差异。 结果 机构内部考核的真实性、规范性等指标普遍高于上级考核结果。 结论 内部考核中考核人员容易与居民沟通并得到居民的配合,容易得到更为真实的信息;但是基层绩效考核人员的能力有待提高,同时应注意避免主观因素的影响;上级考核规范性强,但是不易得到居民配合。因此,建议充分利用客观的考核方式,并充分考虑山区的经济文化特点,改进家庭医生签约服务考核工作的方式方法,使其能够真正反映山区实际工作情况,切实起到促进家庭医生签约工作开展的目的。 

Difference analysis of higher-level and internal assessment of family doctors' contracted services in community health service institutions in suburban areas of Beijing

Objective To understand the difference between the results of the higher-level assessment and the internal assessment of family doctors' contracted services in community health service institutions in suburban areas of Beijing, analyze the reasons and put forward countermeasures. Methods Collection of the assessment data of family doctor contracted service in a community health service center in Beijing suburban mountainous area from January 2018 to April 2018 was made, including higher-level and internal assessment. Institutional internal assessment personnel are responsible for carrying out internal assessment after unified training; at the same time, higher authorities carry out the same project assessment of the institution. Examiners at both levels checked and understood the amount of work completed by the organization via the information system. The telephone interview method was used to understand the residents' perception of the service and to judge the authenticity of the contracting work. Assessment was made regarding the quality of family doctor's contract service and health management of hypertension and diabetes patients. The authenticity and effectiveness of the work of the organization were comprehensively analyzed, and the development of the work was assessd according to above results. The study compared and analyzed the differences between the internal assessment results of the organization and those of the higher authorities. Results The authenticity and standardization of internal assessment are generally higher than the results of higher-level assessment. Conclusion In the internal assessment, the assessors are easy to communicate with the residents and get the cooperation of the residents, so they can get more real information.However, the ability of grass-roots performance appraisal personnel needs to be improved, and attention should be paid to avoid the influence of supervisory factors.Superior assessment is normative, but it is not easy to get the cooperation of residents.Therefore, it is suggested that we should make full use of objective assessment methods and take full account of the economic and cultural characteristics of mountainous areas, improve the methods of assessment of family doctors' contractual services, so that they can truly reflect the actual working conditions in mountainous areas and effectively promote the development of family doctors' contractual work.