北京市社区医务人员家庭医生式服务认知现状研究

目的 了解社区医务人员对北京市家庭医生式服务的认知情况，为进一步推广家庭医生式服务提供对策和建议。 方法 采用整群抽样法，抽取北京市城区和郊区各4家社区卫生服务中心，使用自行设计的调查问卷，对2014年3月在岗的医务人员进行现场问卷调查。调查内容包括社区医务人员的基本情况、工作现状及对家庭医生式服务的认知。 结果 共发放问卷469份，回收有效问卷464份，问卷有效回收率98.9%。社区医务人员的学历以大专及以上为主，占85.6%；职称以初级职称为主，占54.3%；社区医务人员的服务形式以坐诊为主；社区医务人员日均工作时间8.5 h，家庭医生式服务的时间占每天工作时间的43.5%；90.9%的团队成员认为工作量比签约前增加了；社区医务人员目前的主要工作内容排在前3位的是:健康咨询、电话随访、健康档案管理和慢性病管理；93.4%的医务人员回答了解家庭医生式服务的概念；38.9%的医务人员认为政府及有关部门的考核激励措施有效；72.6%的医务人员愿意成为社区卫生服务团队中的一员；89.7%的医务人员赞同实行社区卫生首诊制；53.4%的医务人员认为现有的法律法规不能保障社区卫生服务人员开展家庭医生式服务；73.7%的医务人员认为开展家庭医生式服务对缓解“看病难、看病贵”现象有作用；90.9%的医务人员认为开展家庭医生式服务很重要；医务人员对家庭医生式服务认知度越高，其成为团队成员的意愿就越强。 结论 现阶段北京市社区医务人员对家庭医生式服务的认知度较好，但要进一步推广家庭医生式服务，从医务人员方面要解决社区医务人员数量不足、开展服务缺乏有效的法律法规保障、无有效的激励机制措施的问题。 

Assessment of current cognitive status in community medical staffs about family doctor service in Beijing

Objective To investigate the current cognitive status in community medical staffs about family doctor service in Beijing,and provide strategies and suggestions for further promotion of the family doctor service. Methods The selfdesigned questionnaire for basic condition,current working condition and their cognition of family doctor service was used to survey in March,2014 among the medical staffs from 8 community health service centers(4 from urban area and 4 from suburbs) that were selected by cluster sampling. Results A total of 469 questionnaires were sent out,464 valid questionnaires were returned and the valid rate was 98. 9%. Of all the community medical staffs,85. 6% had a degree of college or above; 54. 3% were primary professional title; the major form of the service was the clinic; the daily working hours of the community medical staffs was 8. 5,family doctor service time took up 43. 5% of the working time per day; 90. 9% of the team members believed that the workload was more than before the signing of the contract; the health consultation,telephone follow-up,health record management and chronic disease management were the main job of the community medical staffs; 93. 4% of the medical staffs could answer the concept of family doctor service; 38. 9% of the medical staffs thought that the assessment and incentive measures from the government and relevant departments were effective; 72. 6% of the medical staffs were willing to become a community health service team member; 89. 7% of the medical staffs agreed to implement a community health care system; 53. 4% of the medical staffs thought that the existing laws and regulations could not protect community health service personnel to carry out family doctor service; 73. 7% of the medical staffs thought that the development of family doctor service could ease the "medical treatment difficult,expensive"phenomenon; 90. 9% of medical staffs thought that the family doctor service was very important; The higher the awareness of the medical staff on the family doctor service,the greater the willingness of the team members to become a member of the team. Conclusion At present,the current cognitive status of community medical staffs on the family doctor service in Beijing is better. The further promotion of the family doctor service need more community medical personnel,support of law and effective incentive measures.