我国家庭医生签约服务政策执行研究

A study on the implementation of family physicians contracted service

家庭医生签约服务是深化我国医药卫生体制改革、实现"全民健康"战略目标的重要选择。为有效推进签约服务工作,国家陆续出台多项政策文件,全国各地也在积极探索,成效显著。但是,目前仍存在多重问题制约着签约服务向纵深处推进。本研究参考"三圈"理论,从政策价值、政策资源、政策推动力3个维度对政策执行情况进行研究,分析发现执行过程中存在的主要问题有家庭医生数量不足、配套政策不完善、年轻健康群体政策认可度低等。后续应通过充实家庭医生队伍、丰富配套政策、聚焦宣传重点人群等多项优化策略,推动家庭医生签约服务政策长期高效执行。

Family physicians contracted service is an important choice to deepen the reform of China′s healthcare reform and achieve the strategic goal of"health for all".In order to effectively promote the contracted service,the central government has successively issued a number of policy documents,which are echoed by the localities in their proactive explorations,achieving remarkable results.But there are also multiple roadblocks hindering the contracted service to progress.This article referred to the three-circle theory and studied policy implementation from the three dimensions of policy value,policy resources,and policy impetus.A thorough analysis of the problems in the implementation process revealed such main problems as insufficient family physicians,inadequacy of supporting policies and low level of policy acceptance among the young healthy age groups.The follow-up work will promote the long-term implementation of the family physicians contracted service policy by enriching the family physicians team,enriching supporting policies,and focusing on promotions to key age groups.