基于需方的家庭医生签约服务实施效果评价——以慢性病为重点

目的:了解上海市长宁区家庭医生签约服务的实施对签约居民的影响,分析签约服务的政策效果。方法:对长宁区15岁及以上常住居民进行问卷调查,检验签约与非签约人群在认知、慢性病服务利用和服务评价方面的差异。结果:共有2 886位居民参与研究,其中621人(21.52%)已经签约。签约集中在老年人和慢性病人群,签约组居民在服务认知、评价方面显著高于非签约组,签约的慢性病人群在社区就诊、慢性病管理防治、慢性病医疗费用控制方面均优于非签约的慢性病人群。结论:家庭医生签约服务成效明显,签约有利于引导居民有序就医、控制医疗费用、改善慢性病防治、提高服务评价和依从性,为推动签约服务提供了科学依据。

The performance evaluation based on the demand side of the family doctor contract service: A focus on chronic diseases

Objective: To understand the impacts of implementation of the Family Doctor Contract Services to community residents contracted to analyze the effects of contracted services policies in Changning, Shanghai. Methods: A questionnaire survey and inspection was conducted among residents over 15 years old, targeted to test the difference in recognition, chronic disease service utilization and healthcare evaluation between residents who have signed a contract and those who have not. Results: There are 2886 residents who participated in the study, a total number of which 621 (say 21.52%) are already contracted. The contract mostly focused on the elderly and chronic disease patients, who are much higher scored in cognitive evaluation than the non-signatory residents, and are much better in community health service utilization, chronic disease management and chronic medical expenses which are higher for non-contracted crowd. Conclusion: The effect of signing a family doctor is significantly positive. Through contraction, it is well conducted to ordered medical treatment, controlling medical expenses, improving chronic disease management, increasing service evaluation and compliance. And it also provides strong data-based evidence to promote the family doctor contraction service.