| 引用本文：何江江, 张天晔, 王冬, 许速, 王玲, 曹剑峰, 杨超, 谢春艳, 胡善联.上海市家庭医生“1+1+1”医疗机构组合签约机制的设计思路与实施障碍因素分析[J].中国卫生政策研究,2018,11(12):24-28 |
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| 上海市家庭医生“1+1+1”医疗机构组合签约机制的设计思路与实施障碍因素分析 |
| 投稿时间：2018-03-15 修订日期：2018-07-04 PDF全文浏览 HTML全文浏览 |
| 何江江1,2, 张天晔3, 王冬3, 许速3, 王玲3, 曹剑峰4, 杨超3, 谢春艳1, 胡善联1 |
1. 上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所) 上海 200040;
2. 复旦大学公共卫生学院 上海 200032;
3. 上海市卫生健康委员会 上海 200125;
4. 上海市卫生健康委员会信息中心 上海 200040 |
| 摘要:上海市作为全国家庭医生制度起步最早的城市，对家庭医生签约机制开展了积极的探索，已从“以软签约为主，引导居民认识、接触与逐步接受家庭医生服务”发展到“医疗机构组合模式的紧密型签约”。本文从调整背景、设计思路、进展与障碍因素等方面系统分析了上海市“1+1+1”医疗机构组合签约机制的实施现状，并基于实施障碍因素分析，提出了从提升全科医生数量与能力和优化现有薪酬分配制度等方面的完善建议。 |
| 关键词:家庭医生 医疗机构 签约服务 机制 上海市 |
| 基金项目:美国中华医学基金会卫生系统研究与政策转化合作项目（14-190）；第四轮上海市公共卫生体系建设三年行动计划（2015-2017）（GWIV-33）；循证公共卫生与卫生经济学（15GWZK0901） |
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| Analysis of the design ideas for “One community health center,One district hospital and One municipal hospital” contract service mechanism of family doctor in Shanghai and its barrier analysis during implementation |
| HE Jiang-jiang1,2, ZHANG Tian-ye3, WANG Dong3, XU Su3, WANG Ling3, CAO Jian-feng4, YANG Chao3, XIE Chun-yan1, HU Shan-lian1 |
1. Shanghai Health Development Research Center(Shanghai Medical Information Center), Shanghai 200040, China;
2. School of Public Health, Fudan University, Shanghai 200032, China;
3. Shanghai Municipal Health Commission, Shanghai 200125, China;
4. Information Center of Shanghai Municipal Health Commission, Shanghai 200040, China |
| Abstract:Shanghai is the earliest city in China for starting family doctor system at national level. It has actively explored the contract service mechanism between residents and family doctors. It has developed from "soft contract signing of guiding residents to understand, contact and gradually accept family doctor services" to the "main and close contracting using the comprehensive service from medical institutions".This paper systematically analyzed the implementation status in "one community health center, one district hospital and one municipal hospital (1+1+1)" contractservice system of family doctor in Shanghai from the aspects of adjustment background, design ideas, progress and obstacles of the policy. Based on the analysis of barriers to the policyimplementation, some suggestions were put forward including the improvement of the contract service system in order to increase the number and build the capacity of general practitioners, and the optimization of the existing payment distribution systems. |
| Key words:Family doctor Medical institutions Contract service Mechanism Shanghai |
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