基于上海市某社区信息化的家庭医生签约服务效果评价

Effect evaluation on information-based family-doctor contract service in a community of Shanghai

【目的】探讨信息化手段支撑下的家庭医生签约服务效果。【方法】采集2016年和2017年同期某社区在上海市社区卫生服务云管理平台上家庭医生工作完成情况数据,并进行比较分析。【结果】2017年60岁及以上老年人签约率、社区居民"1+1+1"签约率、高血压和糖尿病管理对象的签约率分别比2016年增加9.12%、4.14%、16.8%和21.93%。2017年该社区居民在社区人均月累计就诊次数和月人均门诊费比2016年增加,2017年签约居民月累计就诊人次数和月人均门诊费比2016年有所下降。2017年签约高血压和糖尿病患者的有效控制率比2016年有所提高。高血压和糖尿病管理率与2016年基本持平。【结论】家庭医生签约服务可引导居民逐渐改变就医习惯,社区卫生服务利用度增加,为分级诊疗模式的推行奠定了基础。

[Objective] This paper aims to analyze the effect of family-doctor contract service under the support of information on local residents. [Methods] Through the ＂Cloud Computing Management Platform＂of Shanghai municipal health service system,all working data on family doctors in a community health service center in the years of 2016 and 2017 were collected and a comparative analysis was collected.[Results]Compared with the number of local residents receiving contract medical service in 2016,the number of over sixty-year-old citizens increased by 9. 12% in 2017,local residents receiving ＂1 ＋ 1 ＋ 1＂type contract service increased by 4. 14% in 2017,participants in hypertension and diabetes management were enhanced by 16. 8% and 21. 93% in 2017. Compared with that in 2016,cumulative monthly hospital visits per capital and average out-patient monthly medical expenditure of local residents increased in 2017,and however,decreased in 2017 for residents with family-doctor contract service. The effective control rate of hypertension and diabetes patients receiving contracted service in 2017 was better than that of 2016. The management rate of hypertension and diabetes in 2017 was basically the same as that in 2016. [Conclusion] The type of family doctors offering contracted medical service is conducive to the change in residents’ general practices in seeking medical service from top hospitals gradually. Meanwhile,residents are encouraged to receive more medical services from community health service centers. Therefore,the new type service of family doctors has established a solid foundation for the implementation of the degraded diagnosis and treatment model.