上海市长宁区家庭医生人员配置及服务能力调查

A survey of family doctors＇ staffing and service capability in Changning district, Shanghai

目的在家庭医生签约服务与医保支付方式联动改革的背景下，对上海市长宁区家庭医生人员配置和服务能力建设现状进行评价。方法搜集卫生部门2013年至2015年度报表中家庭医生人力配置相关数据，并通过2013年、2016年2期长宁区家庭医生跟踪调查，了解其资质、培训、工作压力、工作胜任等情况。采用描述性统计分析相关数据。结果2015年每万人口全科医师数量为2．75人，经过资质认证的全科医师占比达97．20％，超过半数家庭医生参加过规范化培训。68．80％（97／141）的家庭医生表示工作压力较大，超过80％的家庭医生遇到过医疗服务相关技术问题。结论长宁区家庭医生的数量与质量得到较大提升，能够提供基本满足居民需求的签约服务。但家庭医生数量仍存在缺口，且面临较大工作压力，其工作胜任能力有待提高。应继续扩充家庭医生数量，加强规范化培训，完善薪酬激励机制、职业发展机制和协同支持机制，进一步夯实队伍基础，发挥服务效能。

Objective To evaluate the present family doctors staffing and service capacity building in Changning under the linkage reform of contracting service of family doctors and health insurance payment. Methods The staffing data of family doctors were collected from the 2013 -2015 annual reports, while the data on their qualifications, training, job stress and competence were collected from two follow-up investigations. These data were analyzed with descriptive statistics. Results In 2015, the number of family doctors totaled 27 000, up to 2. 75 doctors per 10 000 people. Over 97% of the family doctors were qualification certificated. More than half of the family doctors participated in the standardized training. 68. 80% （97/141） of the family doctors complained overwork. More than 80% of the family doctors had encountered technical problems with medical services. Conclusions The number and competence of family doctors in Changning have been greatly improved to satisfy contracting services of the residents to a minimal extent. However, more family doctors are needed, as they still face much work stress. The family doctors call for standardized training, better payroll and incentive mechanism, better career development and coordinated support mechanism, as well as better team building for greater performance.