家庭医生签约服务的激励机制内涵分析——基于厦门市“三师共管”模式

Incentive Mechanism for the Delivery of Family Doctor Services:a Case Study of Xiamen's Practice for Promoting the Specialty Physician-general Practitioner-health Manager Management

福建省厦门市以慢性病(高血压、糖尿病)为突破口,以构建整合型卫生健康服务体系为目标,基于基层医疗卫生机构全科医师、健康管理师和三级医院专科医师,创设了具有厦门特色的“三师共管”家庭医生签约服务模式。厦门市“三师共管”模式在打造“多快好省”品牌服务的同时,进一步完善了家庭医生签约服务的激励机制,通过建立合理的签约服务费用筹资与分配机制、绩效考核与评价机制及非经济激励机制,提高了基层医务人员的收入,极大地调动了基层医务人员的工作积极性,促进了家庭医生签约服务质量与水平的提升及签约率的大幅提高,产生了良好的医患联动,从而形成并完善了一整套柔性引导“患者愿意去、基层接得住、医院舍得放”的制度创新成果。

To develop an integrated healthcare system,Fujian's Xiamen has made many efforts,for example,it has produced a featured healthcare delivery model,that is,providing hypertension and diabetes patients with tertiary care specialty physician-primary care general practitioner-health manager management.While enhancing the efficiency and quality of the management with low cost,Xiamen improves the incentive mechanism for family doctors.By establishing and implementing systems for financing for carrying out family doctor services,distributing the service fee,and appraising and assessing performance as well as non-financial incentive mechanisms,Xiamen has improved the income and working enthusiasm of primary healthcare workers,and the quality and contracting rate of family doctor services as well as patient-doctor communications,manifesting the initial effectiveness of using innovative systems to facilitate the implementation of key actions of"patients are willing to visit primary care,primary care workers are capable of providing care for patients,and tertiary hospitals are willing to transfer patients to primary hospitals"to achieve tiered diagnosis and treatment.