| 引用本文：林玲, 张小娟, 朱坤.家庭医生签约服务对医防结合的影响[J].中国卫生政策研究,2018,11(12):29-34 |
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| 家庭医生签约服务对医防结合的影响 |
| 投稿时间：2018-01-23 修订日期：2018-04-09 PDF全文浏览 HTML全文浏览 |
| 林玲1, 张小娟2, 朱坤3 |
1. 北京师范大学社会发展与公共政策学院 北京 100875;
2. 中国医学科学院医学信息研究所 北京 100020;
3. 中国财政科学研究院 北京 100142 |
| 摘要:目的：分析家庭医生签约服务对于医防结合的影响及其作用机制。方法：采用典型抽样的方法，调查了七个地区的541名家庭医生团队成员，并对家庭医生团队和相关知情人进行了个人深入访谈和焦点组访谈。定量资料主要采用描述性统计分析；定性资料采用NVIVO9.0软件进行编码、归纳和总结。结果：不同的签约服务模式对医防结合的影响不同。采用家庭医生团队的签约服务有助于促进医防结合；团队成员得到有效激励的签约服务有助于促进医防结合，个人付费的签约服务更有助于促进医防结合；服务内容包括基本医疗和公共卫生服务的家庭医生签约有助于促进医防结合。建议：家庭医生签约服务应实施团队签约和个性化有偿签约。设计综合服务包，融合基本公共卫生服务项目和基本医疗及个性化健康管理服务项目，体现医防结合理念。探索基本公共卫生经费与医保基金融合路径，加强医防结合，促使全科医生从服务守门人向健康守门人转变。 |
| 关键词:家庭医生 签约服务 公共卫生 预防 |
| 基金项目:国家自然科学基金项目（71573276） |
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| The effects of family doctors' contracting servics on the integration of medical care and prevention |
| LIN Ling1, ZHANG Xiao-juan2, ZHU Kun3 |
1. School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China;
2. Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China;
3. Chinese Academy of Fiscal Sciences, Beijing 100142, China |
| Abstract:Objectives:To analyze the effectsof family doctor contracting service on the integration of medical care and prevention and its mechanism.Methods:Based on the representative sampling, 541 family doctors from seven districts were surveyed, and focus group and personal interviews were conducted withfamily doctors and other relevant informants. Descriptive statistical analysis was mainly used to analyze quantitative data and NVIVO 9.0 was used for encoded qualitative data. Results:Different contracted service models have different effects on medical protection on medical care and prevention. The contractingservice with the family doctor is helpful to facilitate the integration of medical care and preventive treatment; the signing service that helps the team members to get effective incentives and personal paid contracts can help promote the combination of medical defense and preventive treatment; whereby the service content includes basic medical treatment. Moreover, signing a family doctor contract with public health services can also help promote medical integration. Suggestions:Family doctor contracting services should implement team and individual contracted services. Designing a comprehensive service package that integrates basic public health service projects and basic medical and personalized health management services should be prioritized to reflect the concept of covered medical care and preventive treatment. A new approach to explore the path of integration of basic public health and medical insurance fundsshould be found to strengthen the combination of medical and preventive measures, and promote the transformation of general practitioners from service gatekeepers to health gatekeepers. |
| Key words:Family doctor Contract service Public health Prevention |
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