上海市长宁区家庭医生责任制实施现状与发展策略研究

目的研究上海市长宁区家庭医生责任制尤其是全科医生执业方式与服务模式改革的实施现状、政策成效与发展策略。方法收集改革的相关指标,如有效签约率、社区定点就诊率、家庭医生定点率和转诊到位率等主要监测指标来考察改革的政策成效和存在的问题。结果实施全科医生执业方式和服务模式改革之后,家庭医生人均有效签约服务人数、有效签约率、社区定点就诊率、家庭医生定点就诊率和转诊到位率等关键指标分别达到了568人、23.00%、74.00%、56.00%和74.00%。签约居民对家庭医生的依从性有了明显的提高,但未来家庭医生责任制改革的深化也面临着能力与动力方面的挑战。结论需要围绕组织管理机制、协同服务机制和补偿激励机制＂一体、两翼、三个机制＂下有价值的服务产出为核心目标来深化家庭医生责任制改革。

The Implementation Status a nd D e velopment Strategies of Family Doctor Responsibility System in Changning District/

OBJIECTIVE To study the implementation status, the policies effectiveness and the development strategies of the Family Doctor Responsibility System especially the service model reform of the general practitioner in Changning District. METHODS To collect the reform-related indicators, such as effective contract rate, community sentinel clinic rate, fixed rate of family doctor, referral rates and other major monitoring indicators in place to examine the effectiveness and problems of the reform. RESLUTS After the implementation of GP practice mode and service mode reform, key indicators such as the per capita valid service contract number of family doctors, effective contract rate, community sentinel clinic rate, fixed rate of family doctor and referral rates are up to 568 people, 23.00%, 74.00%, 56.00% and 74.00%. The compliance of the signed residents to family doctor has been significantly improved, but the future reform of the Family Doctor Responsibility System is also facing the challenges of capacity and power. CONCLUSION It needs to deepen the reform of the family doctor system focus on organization management mechanisms, collaborative service mechanism and compensation incentives under the valuable service as the core target.