社区家庭医生签约对老年人医疗服务利用影响的实证研究

Research on the Impact of Community Family Doctor Contracting on the Utilization of Medical Services for the Elderly

社区家庭医生签约是深化医疗卫生体制改革和落实“健康中国”战略的重要举措,对提高老年人健康水平和医疗服务利用可及性具有重要影响。本文采用北京市某社区医院2018年1月至2021年7月的居民月度就诊数据,分析社区家庭医生签约对老年人医疗服务利用的影响。研究发现:社区家庭医生签约显著降低了老年人的医疗费用支出,显著减少了老年人的就诊频率与就诊科室数量,有利于促进分级诊疗和优化医疗资源配置。为完善社区家庭医生制度,本文提出以下建议:加强社区家庭医生相关政策宣传,引导居民积极签约;完善社区家庭医生服务工作的诊疗流程与标准,提高医疗服务质量与效率;深化医保支付方式改革,充分发挥医保经济杠杆的作用,完善分级诊疗制度。

Community family doctor contracting is an important measure to deepen the reform of medical and health system and implement the"Healthy China"strategy,which has an important impact on improving the health level of the elderly and the accessibility of medical service utilization.Based on the monthly medical data of residents in a community hospital in Beijing from January 2018 to July 2021,this paper analyzes the impact of community family doctor contracting on the utilization of medical services for the elderly.The study finds that community family doctor contracting significantly reduces the medical expenses of the elderly and the frequency of visits and the number of departments for the elderly,and is conducive to promoting hierarchical diagnosis and treatment and optimizing the allocation of medical resources.In order to improve the community family doctor system,this paper puts forward the following suggestions:strengthen the publicity of policy related to community family doctor service so as to guide residents to contract actively;improve the diagnosis and treatment process and standards of community family doctor so as to improve the quality and efficiency of medical services;deepen the reform of medical insurance payment mode,give full play to the role of medical insurance economic leverage,and improve the hierarchical diagnosis and treatment system.