老年人家庭医生签约制度的信任困境与机制完善

Trust Dilemma and Mechanism Improvement of the Family Doctor Contracting System for the Elderly

老年人家庭医生签约制度的实践运作透射出老年人的诸多信任困境,主要体现在制度设计、履约能力以及首诊制等方面。反映出的这种信任困境的根本原因还在于家庭医生签约制度本身不够完善,制度信任是关键,必须对该制度进行“适老化”的改革。家庭医生签约制度的全面法治化、家庭医生团队履约能力的规范化和家庭医生首诊激励制度的规范化,这三项举措将有助于提升老年人的制度信任水准,并最终有助于老年人家庭医生签约制度设计初衷的实现。

The practical operation of family doctor contracting system for the elderly reveals many trust dilemmas faced by the elderly,which are mainly reflected in aspects such as system design,fulfillment capabilities,and the first-diagnosis system.The fundamental reason for the trust issues lies in the inadequacies of the family doctor contracting system itself,where institutional trust is the key.To address this,the system must undergo"elder-friendly"reforms.Three key measures can help enhance the level of institutional trust among the elderly:comprehensive legalization of the family doctor contracting system,standardization of the performance capabilities of family doctor teams,and the regulation of incentives for the family doctor first-diagnosis system.These efforts will ultimately contribute to the realization of the original goals of the family doctor contract system for the elderly.