家庭医生签约服务现状及机构管理者满意度分析

Analysis on the Work Status and Institution Administrator Satisfaction Contract Servises of Family Doctors

目的了解基层医疗机构家庭医生签约服务实施情况和机构管理者满意度情况,为进一步推进家庭医生签约服务提供对策建议。方法抽取参与江苏省家庭医生签约服务培训的149名基层医疗卫生机构管理者,通过问卷调查,了解机构家庭医生签约服务情况及满意度等。结果 72家(43.3%)机构家庭医生签约服务由基本公共卫生服务经费支持,58家(38.9%)机构目前签约服务主要注重保证已签约居民的服务质量和满意度,96家(64.4%)机构印发了相关宣传文件,60家(40.8%)机构未制定任何激励措施;管理者对家庭医生签约服务各项配套措施总满意度较低;城乡管理者满意度在医保的配套支持(t=-2.72,P=0.01)和上下级医院的信息系统整合(t=-2.45,P=0.02)两个方面有差异。结论加强医保参与,完善配套措施;提升基层医疗卫生机构服务能力,坚实家庭医生服务基础;注重考核激励,促进长效运行;加快信息化建设,完善技术支撑。

OBJECTIVE To investigate the family doctor service situation and satisfaction degree of institution administrators and pro-vide countermeasures and suggestions for its improvement. METHODS 149 institution administrators in family doctor service trainingof Jiangsu were adopted based on self-designed questionnaire, to know signing service situation of family doctor and satisfaction situ-ation through questionnaire. RESULTS 72 cases（43.3%） of the institutions that carried on the family doctor contracted services weresupported by the basic public health services funds, 58 cases（38.9%） of the institutions mainly focused on ensuring the quality andsatisfaction of the contracted residents, 96 cases（64.4%） of the institutions issued relevant publicity documents,60（40.8%） of the in-stitutions did not develop any incentive measures; the administrators had a low degree of satisfaction for each supporting measures;the administrators satisfaction degree in urban and rural differs in 2 aspects：supporting measures of medical insurances（t=-2.72, P=0.01） and information system integration of upper and lower hospitals（t=-2.45,P=0.02）. CONCLUSION In needed to strengthen theparticipation of medical insurance to improve the supporting measures; enhance the service capacity of primary health care institu-tions to build a solid foundation for the family doctor service; focus on evaluation and incentive to promote long-term operation;accel-erate the construction of information to improve the technical support.