Current status of family doctor service system undertaking in Beijing suburban areas: focus group interviews with general practitioners
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摘要: 目的 北京市开展家庭医生式服务5年,目前对家庭医生式服务的研究多集中于城区家庭医生式服务现状与对策研究、服务模式及激励机制研究等,而对农村家庭医生式服务极少涉及。本研究通过对郊区县全科医生进行访谈,了解北京市郊区县家庭医生式服务开展的现况,为今后郊区县家庭医生式服务的发展提供对策和建议。 方法 2014年11月—2015年1月,对来自北京市10个郊区县16名全科医生进行专题小组访谈,并对访谈资料进行编码、归类、精简,总结出访谈主题。 结果 通过对北京郊区县全科医生的访谈,目前家庭医生式服务的开展情况有如下特点:①家庭医生式服务内容与患者需求尚有差距,导致患者对家庭医生式服务认可度低;②家庭医生式服务配套政策与措施急需完善;③基层待遇低,导致社区卫生人员不足,家庭医生式服务增加了日常工作量;④远郊区县家庭医生式服务主要签约方式为上门签约,服务方式为定期下乡巡诊;⑤远郊区县的家庭医生式服务团队中乡村医生承担了重要角色,防保人员的作用有待发挥;⑥家庭医生式服务未达到预期成效,但医患关系得到改善。 结论 北京市郊区县家庭医生式服务的发展,应充分发挥乡村医生的作用;继续加强对家庭医生式服务的宣传引导;同时应优化家庭医生式服务内涵,满足重点人群的卫生服务需求;不断完善与家庭医生式服务相配套的政策与措施,促进郊区县家庭医生式服务发展。Abstract: Objective As family doctor service has been carried out for approximately five years in Beijing,while the study of family doctor service mainly focus on current situation,pattern and incentive mechanism in Beijing urban area,little research is available in suburb area.Therefore,in order to provide reasonable countermeasures and suggestions to promote the development of family doctor service in Beijing suburb areas,related interviews were conducted for some general practitioners,which is helpful for us to know the current situation of the family doctor service. Methods Sixteen general practitioners(GPs),from ten suburb community health service institutions of Beijing,were interviewed in the form of focus group interviews from November,2014 to January,2015,and interview data were coded,classified,streamline,so as to sum up the interview subjects. Results From the interview,the family doctor service condition has been revealed:Family doctor service content can't meet the need of the patient,which causes the patient's low recognition to the family doctor service.Related policies for family doctors service system were still needed to be strengthened.Low incomes lead to the short of the community health workers,the family doctor service increases daily work.In suburb areas,the mainly way of signing contract in the family doctor service is home signing,and the mainly way of serving is providing regular patrol medical service.In suburb areas,rural doctors play an important role in family doctor service team,the staff who provide prevention and healthcare can't play an efficient role.The family doctor service fails to reach the expected effect;however,the relationship between doctors and patients has been improved. Conclusion In order to develop the Beijing suburb family doctor service,the rural doctor should play their efficient role;we should strengthen the proper publicity and guidance on family doctor service system;optimize the content of family doctor service system,meet the demand of the key crowd;and improve the matching policies of family doctor service system continuously to promote the development of suburban family doctor service.
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