县乡村一体化下乡村医务人员组建全科团队开展家庭签约服务意愿调查

The medical staffs in rural areas willing investigation for assembling the general practitioner team to develop family doctors contract service based on integration of country and rural health services

目的了解县乡村一体化背景下的乡村医务人员通过组建全科团队开展家庭签约服务的意愿及影响因素,为农村地区实施家庭医生签约服务提供参考依据。方法对实行县乡村一体化的大方县长石镇的乡村医务人员进行深度访谈和问卷调查,内容包括对家庭医生签约服务的了解程度、胜任家庭签约服务的能力评价、组建全科团队开展家庭签约服务的意愿及影响因素。结果 23名(30.7%)医务人员比较了解并完全能够胜任家庭签约服务;42名(56.0%)医务人员认为必要再提高业务水平来承担家庭签约服务,有35名(46.7%)希望获得进修学习的机会以提高自身业务水平;46名(61.3%)医务人员认为签约居民适合人数在1 000人以内;57名(76.0%)医务人员愿意加入全科团队开展家庭签约服务,影响医务人员愿意加入全科团队开展家庭签约服务的因素主要有医务人员的待遇、医疗技术水平及获得居民的支持和理解,分别占65.3%、34.7%、33.3%;23名(30.7%)乡村医务人员认为开展家庭签约后工作量会增加。结论县乡村一体化下乡村医务人员组建全科团队开展家庭签约服务意愿高,但存在新进医务人员及村医对签约服务内容了解不全面,待遇、医疗技术水平和居民理解支持是影响组建全科团队开展家庭签约服务的关键。提高待遇、为其提供进修学习机会、加强宣传可提高乡村医务人员组建团队开展签约服务的吸引力。

Objective To investigating the willing and the effects factors of medical staffs in rural areas who assembling the general practitioner team to develop family doctors contract service which based on integration of country and rural health services, so that we can provide references for developing family doctors contract service in rural areas. Methods Depth interview and questionnaire investigation was carried out in medical staffs of Changshi town of Dafang county where have integrated of country and rural health services. The content includes ：how well they know about the family doctors contract service,estimating their competence for family doctors contract service, the willing and the effects factors to join the general practitioner team to develop family doctors contract service. Results 23（30.7%） people showed that they are understand better and well qualified for the family doctors contract service, 42（56.0%） people showed that improving their medicine level to undertake the family doctors contract service is necessary, 35（46.7%） people hope that they have opportunities for further study to raise their medicine level, 46（61.3%） people showed that the number of contracted residents should be hemmed up within 1 000 people, 57（76.0%） people showed that would like to join the general practitioner team to develop family doctors contract service. There are three major factors that influence their wishes to join,treatment,medical technology, support and understanding of the residents,accounting for 65.3%,34.7% and 33.3%, respectively.23（30.7%） people showed that their workload increased after developing family doctors contract service. Conclusion The willing of medical staffs in rural areas who assemble the general practitioner team to develop family doctors contract service is higher, but the new medical staffs and village doctors knowledge about contract service are incomplete. Treatment, medical technology, support and understanding of the residents are the key effect factors for assembling the general practitioner team to develop family doctors contract service,increasing treatment,providing opportunity for further study, enhancing public awareness can improve the attraction for medical staffs in rural areas who assembling the general practitioner team to develop family doctors contract service.