国内外家庭医生签约服务团队评估指标研究进展

Recent Advances in Assessment Tools for Family Doctor Teams

随着家庭医生制度的推进与发展,家庭医生签约服务团队成为基层卫生服务的主要提供者,这对家庭医生签约服务的评估工作提出了新的要求。本文综合分析了国内外家庭医生签约服务团队评估指标的研究进展。国外方面以英国、美国、欧洲、澳大利亚、加拿大等为代表,认为以结构-过程-结果模型为主的传统评估指标正在被一些更加关注团队组织环境、内部关系、心理状态、持续改进的模型所替代。国内近些年开始以家庭医生团队为对象构建评估指标。研究方法多样,但缺乏高质量的理论模型支撑,且未对构建的指标进行信效度检验;指标维度较单一,尤其是缺乏团队关系、情感心理、持续改进方面的指标。结合国际经验,研究者建议以投入-中介-产出-再投入(input-mediator-output-input,IMOI)模型为理论依据,构建符合我国国情的家庭医生签约服务评估指标。

With the advancement and development of the family doctor system,family doctor teams have become a main provider of primary health services,which has raised new requirements for the evaluation of their services.We comprehensively reviewed recent developments in evaluation tools for family doctor teams:examples from the UK,the US,European countries,Australia and Canada have shown that traditional evaluation tools based on the structure-process-outcome model are being replaced by some models that focus more on the team's organizational environment,internal relationships,psychological state and continuous improvement.In China,the development of assessment tools for family doctor teams has been initiated recently,with major manifestations of various research approaches but lack of high-quality theoretical models,and high-quality reliability and validity tests.Moreover,the assessment tools are lack of diverse domains,and indicators for assessing team relationships,emotions and psychology as well as continuous improvement.On the basis of international experience,we recommend using the input-mediator-output-input model as a theoretical basis to develop highly applicable tools for assessing family doctor services in China.