家庭医生签约服务的“苏州模式”

Suzhou Mode for the Delivery of Contracted Family Doctor Services

家庭医生签约服务是分级诊疗制度的重要突破口,是实现社区卫生服务机构战略转型的主要体现。本文结合苏州市关于建设完善家庭医生签约服务的相关政策,对苏州市开展签约服务的主要做法进行了汇总分析,包括健康市民"531"系列行动计划、医疗联合体建设、特色专科建设、社区信息化建设等。截至2017年底,苏州市签约率达31.4%,重点人群签约率达62.83%;截至2018年底,全市全科医生总数达3 788名,按常住人口计算,每万人口拥有全科医生3.53名。苏州市的分级诊疗模式初步建立,区域慢性病防治取得明显成效。但苏州市的家庭医生签约服务仍存在激励机制不完善、签约居民重点疾病筛查项目发展不平衡等问题,进一步的工作也将围绕上述方面继续做细做实家庭医生签约服务。

The implementation of contracted family doctor services(CFDSs) is an important breakthrough initiative to promote the development of the tiered healthcare delivery system,and is a major manifestation of strategic changes in service delivery modes of community healthcare settings.On the basis of the supportive policies for promoting the development of CFDSs in Suzhou,we summarized and analyzed the primary actions for the delivery of such services in this city,such as the "531" plan of actions for the achievement of healthy citizens objectives,and the construction of regional healthcare consortiums,featured specialties,and community informatization.By the end of 2017,the overall contracting rate in Suzhou reached 31.4%,in particular,it was 62.83% in priority groups.And by the end of 2018,the city owned a total of 3 788 general practitioners(GPs),and had 3.53 GPs per 10 000 permanent residents.Meanwhile,Suzhou has formed its delivery models for CFDSs initially and has made remarkable achievements in chronic disease control and prevention.However,the incentive mechanism for the implementation of CFDSs is still not complete,and the developments of key disease screening projects for contracted residents are unbalanced,which will be improved by further efforts by Suzhou to better the development of CFDSs specifically.