北京市某社区中重度失能老年人家庭医生签约服务利用情况分析

Analysis on Utilization of Family Doctor Contracted Services for Moderately and Severely Disabled Elderly in a Community in Beijing

目的:分析北京市某社区中重度失能老年人家庭医生签约服务及相关中医药服务的利用情况,提出家庭医生签约服务的改进对策。方法:选取2019年1-12月某城市社区≥65岁且符合中重度失能评判标准的162例老年人作为研究对象,采用社区卫生服务机构健康档案数据提取和自制调查问卷结合的方法,通过电话调查方式对中重度失能老年人进行调查,总结该社区失能老年人家庭医生签约服务利用现状及存在的问题,结合国际经验和国内实践,提出针对性的对策建议。结果:该社区失能老年人通过家庭医生签约服务的中医药体质干预,使偏颇体质转变为平和质,占比由2019年的35.2%增加到2021年的48.1%,差异有统计学意义(P<0.05)。失能老年人对于家庭医生签约服务项目中的老年健康评估、物理检查、慢性病随访、中医体质辨识利用率较高,对慢性病长处方、双向转诊利用率较低。结论:通过对失能老年人的家庭医生签约服务利用情况分析,为改进辖区内失能老年人的家庭医生签约服务工作提出了有益举措,进一步提升了失能老年人的健康管理水平。

Objective:To analyze the utilization of the family doctor contracted services and related traditional Chinese medicine services for the moderately and severely disabled elderly in a community in Beijing,and propose the improvement countermeasures of family doctor contracted services.Methods:From January 2019 to December 2019,162 elderly people aged≥65 years who met the criteria for moderate and severe disability in an urban community were selected as the study subjects.The combination pf community health service organization health file data extraction and self-made questionnaire was used to investigate the moderately and severely disabled elderly through telephone survey,summarize the current situation and existing problems of the family doctor contracted services for the disabled elderly in this community,and put forward targeted countermeasures and suggestions based on international experience and domestic practice.Results:The disabled elderly in this community signed a contract with a family doctor to receive traditional Chinese medicine constitution intervention,and the proportion of biased constitution changing to harmony constitution increased from 35.2%to 48.1%,and the difference was statistically significant(P<0.05).The utilization rate of disabled elderly on elderly health assessment,physical examination,chronic disease follow-up and traditional Chinese medicine constitution identification in the family doctor contracted service program was high,and the utilization rate on long-term prescription and two-way referral for chronic diseases was low.Conclusion:Through the analysis of the utilization of the family doctor contracted services for the disabled elderly,it can provide the beneficial measures for improving the contracted services of family doctors for the disabled elderly in the jurisdiction and further improve the health management level of the disabled elderly.