我国家庭医生签约服务绩效评价研究

Studying on The Performance Evaluation of Family Doctor Contracting Services in China

目的:了解我国家庭医生签约服务绩效评价研究现状.方法:系统检索中国生物医学文献数据库、中国知网、万方数据知识服务平台等关于家庭医生签约服务绩效评价的文献,检索时间限定为2008年1月-2018年11月.运用文献计量法和内容分析法对纳入文献进行资料分析.结果:最终纳入分析的文献有29篇.第一作者工作单位为高校和科研机构、政府管理部门、基层医疗卫生服务机构的分别为16篇(55.17%)、3篇(10.34%)、10篇(34.48%);发表于核心期刊的文献为11篇(68.75%),其中《中国全科医学》占5篇(31.25%);华东地区高校学位论文数量最多,为8篇(61.54%).家庭医生签约服务产出评价以服务数量、质量、费用、可及性等方面为主;签约服务结果评价以签约居民的健康状况改善、健康和就医行为的变化及供需方的满意度测量方面为主.文献调研法和德尔菲法是研究使用频次最高的方法,确定权重方法使用较多的是层次分析法和百分权重法.结论:斟酌评价指标的合理性和可操作性;组合使用评价方法;绩效评价研究可在评价内容、模式、指标目标值及方向上继续深入探索.

Objective To explore the status of researches on performance evaluation of family doctor contracting services in China.Methods Related literature on performance evaluation of family doctor contracting services from January 2008 to November 2018 was systematically retrieved from databases of CBM,Wanfang and CNKI.And data was analyzed with bibliometric method and content analysis method.Results A total of 29 cases of literature were included.The first author of which working in universities and research institutions,government departments,grass-roots medical and health institutions was 16(55.17%),3(10.34%)and 10(34.48%),respectively.11(68.75%)cases were published in core journals,in which 5(31.25%)cases published by Chinese General Practice.The greatest number of academic dissertation was in East China.Evaluation on output mainly focuses on the quantity,quality,cost and accessibility of services.And evaluation on results mainly focuses on the residents'improvement of health status,change of healthy life style and medical-seeking behaviors,and the measurement of satisfaction of both sides.The literature research method and Delphi method were the most frequently used method.Analytic hierarchy process and percentage weighting method were used mostly.Conclusion The rationality and operability of the evaluation index should he further considered and combined used.Performance evaluation research can be further explored in terms of evaluation content,model,target value and direction.