需方视角下家庭医生签约服务效果评价及对策研究

Effect evaluation and countermeasure research on family doctors’ contracted service from the perspective of demander

目的从需方视角对农村居民家庭医生签约服务的效果进行评价。方法采用问卷调查和访谈法,随机抽取山东省临沂市沂水县6个行政村居民进行调查,对数据进行描述性分析、χ^2检验。结果共抽样调查了农村居民238人,其中56人(23.5%)已签约家庭医生服务,并有42人(75.0%,42/56)已利用过家庭医生服务。有慢性病者对家庭医生的利用率(84.8%,28/33)高于无慢性病者(60.9%,14/23)(χ^2=4.156,P<0.05);在公共卫生服务方面,对家庭医生签约服务的利用主要集中在建立健康档案(占比92.9%)、接受健康教育(占比64.3%)、老年人健康管理(占比33.3%)等项目。在基本医疗服务方面,主要为接受健康体检及定期随访(占比47.6%)。农村居民对家庭医生签约服务效果评价前三位是看病时间缩短、家庭医生诊断正确率提高、就医花费降低。结论农村居民家庭医生签约服务利用率较高,其中慢性病患者比非慢性病患者利用率高;农村居民满意度较高,续约的意愿较强。

Objective To evaluate the effect of contracted services for rural residents family doctor from the perspective of the demander. Methods The residents from six administrative villages in Yishui County were randomly selected and surveyed by questionnaire and interview method. Results A total of 238 rural residents were enrolled in the study, of which 56 (23.5%) had signed up for family doctor services and 42 (75.0%) had received family doctor services. The utilization rate of family doctor for chronic patients (84.8%, 28/33) was higher than that of non-chronic patients (60.9%, 14/23)(χ^2=4.156 , P <0.05 ).In terms of public health services, the utilization of family doctor contracted services mainly focused on establishing health records (92.9%), receiving health education (64.3%) and health management for the elderly (33.3%).In terms of basic medical services, medical examinations and regular follow-up (47.6%) were the main methods. Rural residents evaluation of the effect of family doctor s contracted service took up the top three: shortening visit time, improving diagnostic accuracy, and reducing the medical cost. Conclusions The utilization rate of contracted services of rural residents in higher, among which the utilization rate of chronic patients is higher than that of non-chronic patients. The satis-faction of rural residents is higher, and the willingness to renew contracts is stronger.