基于家庭医生制度的上海市社区医生认知分析与政策建议(待续)

目的为进一步了解目前上海市社区医生对家庭医生制度认知和愿望,并深入分析这些原因,为上海市医改提出政策建议,特进行该研究。方法随机整群分层抽取上海市中心地区(徐汇区)、上海市城乡结合区(闵行区)、上海市郊区(金山区)社区(家庭)医生1300人,有效回答1142份,回收率87.8%。结果①对于家庭医生的资质,医务人员认为家庭医生应该由31～50岁之间、具备大学(含专科)学历和初级或中级职称、从业在5年以上的基层医疗卫生服务人员来担当。②在家庭医生提供基本医疗服务项目方面,有23.7%的医务人员认为非常必要;在提供公共卫生服务项目方面,认为非常需要的医务人员占26%;对于家庭健康管理服务项目,有50.1%的医务人员认为家庭医生需要提供该服务。在双向转诊方面,有17.77%的医务人员认为家庭医生应该提供此项服务。而关于提供将患者的健康档案信息上报,并在二、三级医院进行门诊预约、检验、检查的服务,则有18.65%的医务人员认为家庭医生应该提供此项服务。③在综合满意度方面,仅有5.5%的社区医务人员对目前的各方面状况表示非常满意。结论上海市社区医生认知较好,要因势利导,制定相关政策,保证家庭医生制度的顺利实现。社区医生培养更是当务之急。

Cognitive Analysis of Community Physicians and Policy Suggestions Based on Family Doctor System in Shanghai City

Objective To further investigate the wishes and cognition of community physicians on the family doctor system in Shanghai city,analyze the reasons for such status and bring up the policy suggestions for the medicine reform in Shanghai city.Methods A cluster random sampling method was used to survey wishes and cognition of 1300 community physicians from Xuhui district,Minhang district and Jinshan district.1142 valid questionnaires were returned(86.75%).Results ①The medical personnel agreed that the community physicians should be the doctors from basic medical and health institutions whose age were at 31 to 50 years,had a university(including college) education and intermediate technical titles,and had a experience of health service more than five years.②The respondents agreed that the community physicians should provide the basic medical services(23.7%),public health services projects(26%),family health care manager(50.1%),two-way referral service(17.77%) and reporting the health and medical records to the supervising authority,the provision of out-patient appointment,examination,inspection services in two or three-level hospital hospitals(18.65%).③Only 5.5% of the respondents showed a very s satisfactory in all aspects of the current situation.Conclusion The cognition status of community physicians for the family doctor system in Shanghai city is better.The government should improve the occasion and formulate the relevant policies to support it,and ensure the successful implement of family doctor system in Shanghai City.The training of family doctors is the immediate task for us.