基于上海“社区云管理”大数据的家庭医生改革后签约居民就诊情况分析

Analysis of Medical Treatment of Contracting Residents after the Reform of Family doctors based on the Big Data of“Community Cloud Management”in Shanghai

目的通过"社区云管理"大数据分析,进一步深化社区卫生服务综合改革,推进分级诊疗工作开展。方法查看上海市"1+1+1签约社区云管理"平台的签约居民就诊流向、频次、费用等资料,比较改革前后的差异性;开展电话问卷调查,分析认知和满意度改变。结果签约居民组合内就诊率从66.19%提高到73.68%,差异显著(P<0.05)。其中,签约社区医疗机构就诊率由27.58%提高到38.73%,签约区级、市级医疗机构就诊率分别由17.04%、21.57%下降到13.12%、20.83%,差异显著(P<0.05);签约居民人月均就诊次数从1.53次下降到1.41次,费用无显著差异;签约居民认知和满意度上升显著(P<0.05)。结论深化社区卫生服务综合改革,提高签约后的有效服务,有效改变了签约居民的就诊流向,合理的分级诊疗服务格局正在得以构建。

Objective:To analyze the"community cloud management"through the big data,the comprehensive reform of community health services is further deepened and the work of hierarchical diagnosis and treatment is promoted.Method:The flow,frequency,cost and other data of"1+1+1 Contract Community Cloud Management"platform in Shanghai are checked in order to compare the differences before and after the reform.A telephone questionnaire was conducted to analyze the changes in cognition and satisfaction.Result:The consultation rate of contracted residents increased from 66.19%to 73.68%,and the difference was significant(P<0.05).Among them,the consultation rates of the contracted community medical institutions increased from 27.58%to 38.73%,the consultation rates of the contracted district and municipal medical institutions decreased from 17.04%and 21.57%to 13.12%and 20.83%,respectively,with significant differences(P<0.05).The average number of visits per month for contracted residents decreased from 1.53 times to 1.41 times,and there was no significant difference in cost.The cognition and satisfaction of contracted residents increased significantly(P<0.05).Conclusion:Deepening the comprehensive reform of community health services and improving the effective services after signing contracts effectively changed the flow of medical treatment for contracted residents,and a reasonable hierarchical medical service pattern is being established.