家庭医生签约服务背景下京郊山区医养结合服务现状及对策探析

陈静静; 王海利; 裴若童; 杨凯文; 彭迎春

doi:10.16766/j.cnki.issn.1674-4152.004006

家庭医生签约服务背景下京郊山区医养结合服务现状及对策探析

doi: 10.16766/j.cnki.issn.1674-4152.004006

1.
北京市怀柔区琉璃庙镇社区卫生服务中心，北京 101409
2.
首都医科大学公共卫生学院，北京 100069
3.
首都医科大学医学人文学院，北京 100069

基金项目:

北京市怀柔区卫生健康委员会2022年科研项目 2022-C-002

北京市怀柔区卫生健康委员会2023年科研项目 2023-A-01

北京市社会科学基金项目 22SRB008

详细信息

通讯作者:
彭迎春，E-mail：pycjql@ccmu.edu.cn

中图分类号: R197.61 R499
计量
- 文章访问数: 8
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- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2024-09-11
- 网络出版日期: 2025-08-14

Analysis on the present situation and countermeasures of combined medical and nursing services in Beijing suburb mountainous areas under the background of family doctor contract service

1.
Beijing Huairou District Liulimiao Town Community Health Service Center, Beijing 101409, China

摘要

摘要: 目的了解京郊山区医养结合服务现状，从家庭医生签约服务团队提供服务和老年居民及其照护者服务需求2个层面分析现存问题并提出改进对策。方法对北京市怀柔区北部山区5个乡镇133名已经签约家庭医生的65岁以上老年居民进行问卷调查，了解目前养老方式和就医情况及其养老、就医服务需求；同时对5家社区卫生服务中心家庭医生签约服务团队医务人员进行问卷调查，了解医养结合服务提供情况。结果接受调查的133名老年居民中，128名(96.2%)选择居家、社区养老，102名(76.7%)主要和配偶互相照护；75.2%(100/133)的老年居民出现健康问题后直接前往乡镇卫生院或村卫生室就诊，12.0%(16/133)的老年居民首先电话咨询家庭医生，根据家医指导后就医。在服务需求方面，有43位(32.3%)提出了上门医疗服务需求，41位(30.8%)提出了经济支持需求。在服务提供方面，位于前三位的是老年人健康管理服务、门诊服务和上门健康评估。结论居家养老是京郊山区老年人主要的选择，社区卫生服务机构和家庭医生是其医养结合服务的主要提供者。目前供需之间仍然存在差距，保障机制也不够完善。建议在落实家庭医生签约服务的基础上，进一步探讨家庭医生在社区居家养老中服务整合及资源协调的作用，全面提升医养结合服务的质量和效率。
- 家庭医生签约服务 /
- 居家社区养老服务模式 /
- 医养结合服务
Abstract: Objective To understand the current situation regarding healthcare integration services in mountainous areas in the suburbs of Beijing, it is necessary to firstly analyze the existing problems and propose countermeasures in terms of the services provided by the contracted family doctor service teams and the services demands of elderly residents and their caregivers. Methods A questionnaire survey was conducted on 133 elderly people over the age of 65, who had signed a contract in five townships and towns in the northern mountainous area of Huairou District, Beijing. Concurrently, a questionnaire survey was conducted on the medical staff of the family doctor contracted service teams of the five community health service centers to understand the situation of the provision of integrated medical care and nursing care services. Results Among the 133 elderly residents who took part in the survey, 128 (96.2%) said they wanted to continue living at home and in the community, and 102 (76.7%) said they mainly took care of each other with their husbands or wives; 75.2% (100/133) of the elderly residents went to the township health center or the village health center directly when they had a health problem, and 12.0% (16/133) of them first called their family doctor; 12.0% (16/133) of elderly residents first call their family doctors for advice and then seek medical treatment. In terms of service needs, 43 individuals (32.3%) expressed a demand for home-based medical services, while 41 (30.8%) requested financial support. Regarding service provision, the top three services offered were health management for the elderly, outpatient services, and in-home health assessments. Conclusion Home-based elderly care is the primary choice for older adults in mountainous suburban areas of Beijing, with community health service institutions and family doctors serving as the main providers of integrated medical and elderly care services. However, there remains a gap between service supply and demand, and the supporting mechanisms are still inadequate.It is recommended that, on the basis of implementing family doctor contract services, further efforts should be made to explore the role of family doctors in integrating services and coordinating resources for community-based home care. This will help comprehensively improve the quality and efficiency of integrated medical and elderly care services.
- Family doctor contracting service /
- Home-based community pension service model /
- Integrated medical and nursing services

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表 1 老年人日常生活中的主要照顾者情况

Table 1. The main caregivers in the daily life of the elderly

主要照顾者	人数(%)
独居	12(9.0)
配偶/伴侣	102(76.7)
子女	12(9.0)
父母	0
兄弟姐妹	1(0.8)
其他亲属	0
邻居	0
护工	5(3.7)
其他	1(0.8)
合计	133(100.0)

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表 2 老年人的精神照顾或娱乐活动主要提供者情况

Table 2. The situation of the main providers of mental care or recreational activities for the elderly

主要提供者	人数(%)
配偶/伴侣	55(52.4)
子女	7(6.7)
父母	0
兄弟姐妹	1(1.0)
其他亲属	2(1.9)
邻居	38(36.2)
护工	1(1.0)
其他	1(1.0)
合计	105(100.0)

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表 3 老年人的医疗服务需求情况

Table 3. The medical service needs of the elderly

医疗服务需求	人次	顺位
与医疗相关的经济支持	10	2
上门医疗服务需求	14	1
体检服务需求	1	7
药物需求	4	4
提高医疗水平的需求	8	3
护理服务需求	2	6
其他服务需求	4	4

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表 4 老年人的养老服务需求情况

Table 4. The demand for elderly care services among the elderly

养老服务需求	人次	顺位
经济支持需求	18	1
设施建设需求	8	3
文化和娱乐活动需求	5	4
生活及照护需求	10	2

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