全科诊疗服务的标准化全科思维模型分析与应用

Analysis and application of standardized general practice thinking model for general practice services

目的探讨一套适合现阶段社区全科医生全科诊疗服务的标准化全科思维模型,实现一个有效、结构化、完整的全科诊疗过程。方法选取2017年1月~2018年12月在广东省深圳市宝安区20家社康中心的160名全科医生作为研究对象。把纳入全人照顾试点的10家社康中心作为观察组,80名全科医生作为观察对象,在此时间段就诊的400例患者为问卷调查对象;同时选择在人员结构、社康规模、就诊人次相接近的10家社康中心作为对照组,80名全科医生为观察对象,在此时间段就诊的400例患者为问卷调查对象。对照组采用传统的自主诊疗模式,观察组采用标准化全科思维诊疗模式。观察两组全科医生职业成就感、自信心,沟通能力、专业知识自我学习能力;观察两组就诊患者疾病诊治准确率、就诊患者满意度、随诊依从性。结果观察组全科医生职业成就感、自信心、沟通能力、专业知识自我学习能力高于对照组(P<0.05)。观察组就诊患者疾病诊疗准确率、就诊患者满意度、随诊患者依从性高于对照组(P<0.05)。结论基于全科诊疗服务的标准化全科思维模型能有效地提高全科医生的服务水平,提高社区全科服务质量,进而改善社区整体全科服务水平。

Objective To explore a set of standardized general practice thinking models suitable for community general practitioners′general practice services at the current stage to achieve an effective,structured and complete general practice process.Methods A total of 160 general practitioners from 20 social health centers in Baoan District,Shenzhen City,Guangdong Province,from January 2017 to December 2018 were selected as research subjects.Ten social health centers included in the whole person care pilot were taken as the observation group,80 general practitioners were taken as the observation subjects,and 400 patients treated in this period were taken as the questionnaire subjects.At the same time,10 social health centers with similar personnel structure,social health scale and number of patients were selected as the control group,80 general practitioners were taken as the observation subjects,and 400 patients treated in this period were takehzas the questionnaire subjects.The control group adopted the traditional independent diagnosis and treatment model,and the observation group adopted the standardized general practice thinking diagnosis and treatment model.The general practitioners′general practitioners′professional achievement,self-confidence,communication skills,professional knowledge self-learning ability of two groups were compared.The accuracy of disease diagnosis and treatment,patient satisfaction and follow-up compliance of the hospitalized patients of the two groups were observed.Results The professional achievement,self-confidence,communication ability and self-learning ability of general practitioners in the observation group were higher than those in the control group(P<0.05).Patients in the observation group had higher disease diagnosis and treatment accuracy,patient satisfaction and patient compliance than those in the control group(P<0.05).Conclusion Standardized general practice thinking model based on general practice service can effectively improve the quality of community general practice service and improve the level of community general practice service.