上海市城市全科服务团队现况调查与分析

An investigation and analysis on current status of general practice service teams in urban Shanghai

目的了解上海市城市全科服务团队工作现况，为今后全科服务团队的可持续发展提供现实依据和理论基础。方法于2008年3月至4月，采用观察法、访谈法和问卷调查的形式，随机抽取上海市8个城区的8个全科服务团队进行现况调查，其中全科团队工作人员40人，团队所在地居民110人。结果全科医生中大专及以上学历人数比例为86％（18／21），中级及以上职称人数比例为52％（11／21）。8个团队中结核病督导管理覆盖率、肿瘤患者管理率、心脑血管疾病管理率、精神病患者管理率达到100％的团队分别为5个、6个、4个和4个。全科团队工作人员对工作环境、内容、收入和职业前景的满意度分别为38％（15／40）、40％（16／40）、5％（2／40）和28％（11／40）。而110名居民中，对就诊环境、医疗质量和服务态度的满意度分别为77％（85／110）、85％（93／110）和89％（98／110）。结论全科服务团队在慢性病管理的实施、双向转诊流程的落实以及全科团队工作人员的满意度等方面尚待进一步改进。

Objective To investigate current status of general practice service teams in urban Shanghai to provide practical evidence and lay theoretical basis for sustainable development of general practice service teams in the future. Methods A cross-sectional study was carried out for 40 staff members of eight general practice service teams in eight urban districts of Shanghai, as well as 110 local residents, by observation, interview and questionnaire methods during March to April 2008. Results Among 21 general practitioners, 86 percent of them （18/21） were graduated from medical colleges or universities with threeyear curriculum or at levels above it and 52 percent （11/21 ） had intermediate professional titles or above. Among the eight general practice service teams, five had full coverage of supervision and management for tuberculosis therapy, six had full coverage of management for tumor patients, four had full coverage of management for cardiovascular and cerebrovascular diseases and four had full coverage of management for patients with mental disorders. In all staff members of eight general practice service teams, 38 percent of them （15/40） were satisfactory with their working environment, 40 percent （16/40） with their work activities, five percent （2/40） with their incomes, and 28 percent （11/40） with their professional future. In 110 local residents, 77 percent （85/110） were satisfactory with service environment, 85 percent （93/ 110） with quality of health-care service and 89 percent （98/110） with the attitude of service teams. Conclusions Implementation of management for chronic diseases and two-way referral, as well as satisfaction of staff members in general practice service teams should be improved further.