我国家庭医生签约服务政策实施效果的文献分析

Meng Cui, Qianqian Yu, Wenqiang Yin, Dong-mei Huang, Kui Sun, Zhongming Chen, Hongwei Guo, Yanli Li, Chun-yan Zhao
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引用次数: 0

摘要

目的探讨我国家庭医生签约服务政策的实施效果。方法采用系统评价方法,提取、描述和分析家庭医生签约服务政策实施效果研究的文献资料。结果共收集了四类80篇论文,其中慢性病患者健康管理效果47篇,老年人健康管理效果11篇,社区首诊效果15篇,医疗费用控制效果7篇。研究主要分布在东部发达地区。家庭医生签约服务提高了慢性病患者和老年人的健康管理效果,提高了社区居民的首诊率,有效控制了医疗费用。现有研究表明,这种服务已取得初步成功。然而,研究也发现了家庭医生短缺和能力低下、质量低下、资源整合和政策宣传不足等常见问题。结论我国的签约服务政策在一定程度上开始发挥“健康守门人”和“成本守门人”的作用。建议加强全科医生的培训,建立健全激励机制,完善信息平台建设,而家庭医生签约服务的实施效果值得在更广的范围、更深的层次和设计规范上进一步研究。关键词:家庭医生;承包服务;实施效果;文献综述
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Literature analysis on the implementation effect of family physicians contracted service policy in China
Objective To study the implementation effects of China′s contracted service policy for family physicians. Methods Systematic evaluation method was used to extract, describe and analyze the literature information of the research on the implementation effect of family physicians contracted service policy. Results A total of 80 papers of four types were rounded up, including 47 on the effect of health management on patients with chronic diseases, 11 on the effect of health management on the elderly, 15 on the effect on the first diagnosis in the community, and 7 on the effect on the control of medical expenses.The research is mostly distributed in the developed areas in the east.The family physicians contracted service promotes the health management effect of patients with chronic diseases and the elderlies, improves the first visit ratio of residents at their community, and effectively controls the medical expenses.Existing research shows that such a service has achieved initial success.However, the research also identified such common problems as the shortage and low competence of family physicians, low quality, resource integration and inadequate policy publicity. Conclusions The contracted service policy in China has begun to play the role of " health gatekeeper" and " cost gatekeeper" to some extent.It is suggested to strengthen the training of general practitioners, establish and perfect incentive mechanism, and improve the construction of information platform, while the implementation effect of contracted services for family physicians deserve further study in a broader scope, deeper level and design specifications. Key words: Family physicians; Contracted service; Implementation effect; Literature review
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