Research On The Evaluation Of The Implementation Effect Of Family Doctor Policy Under The RE-AIM Framewor

Under the dual pressure of aging population and unbalanced supply and demand of medical resources,the importance of family doctors who assume the responsibility of "gatekeeper" of residents’ health has become increasingly prominent.Will the problems of "signing without agreement" revealed in the implementation of previous policies still exist after a period of policy adjustment? Are policy objectives effectively achieved? How to further optimize policies to improve the effectiveness of policy implementation? In order to answer the above questions,this paper takes Guiyang District G as an example,and on the basis of sorting out its development history and implementation,this paper visited 8primary medical and health institutions,effectively collected 553 questionnaires,and semi-structured interviews with 2 relevant responsible persons,4 family doctor team leaders,43 family doctors and 16 residents of Guiyang District G Health Bureau.This paper applies the RE-AIM framework to domestic public health policy evaluation for the first time,and adjusts the adoption to support according to the actual basis of China’s policy environment,and constructs an analysis framework covering 17 indicators in 5 dimensions.The evaluation results showed that the implementation effect of family physician policy was not coordinated in the five dimensions of the adjusted RE-AIM framework.According to the analysis of the evaluation results,four prominent problems in the implementation of family doctor policies were summarized,including "high awareness rate-low signing rate: the contradiction between strong publicity and weak implementation","idealized policy goals: limited resources and vague incentives","weak market competitiveness: personalized contracting services squeezed by basic public health services" and "softening supervision: incomplete expression of policy feedback".Then,from four aspects: implementation mode,decision-making concept,supply content and supervision mechanism,countermeasures and suggestions to optimize the implementation effect of family doctor policy are proposed.From literature research to case analysis,this paper attempts to provide an effective analysis framework for the implementation of family doctor policies,so as to provide a more universal and guiding optimization path for the implementation of family doctor policies.