Study On The Content Of Community Nursing Services In General Practitioner Team

BackgroundCommunity health service (CHS) is a certain tendency when health care service develops continuously. Since the the central government demanded developping the CHS greatly in the central government's Decision on the Health Reform and Development, the model of CHS which suit the condition of the city was actively exploered in different regions. The general practitioner team service model try out to work in shanghai in 2003. Community nurse general practitioner and health care people compose the service team. The team services consist of clinical medicine, preventive medicine, health care, rehabilitation, health education and family planning services, which go in six parts as a whole. Through few years exploration and practice the general practitioner team service model developped greatly, but there are still some problems which need research and solution, such as the personnel quality and arrangment, the effective economic reimbursement mechanisms, the scientific assessment and distribution plan, the content and quality of community nursing service. The definition of service is confused in the team, especially the preventive medicine and health care services. Some services was crossed, service quality was not great satisfaction. Community nursing is the most important content of CHS. There are different services contents and items in different general practitioner team, there are lack of the uniform standard of services contents which is one of the contradictions that hamper the development of CHS. It need to be investigated. The study can promote CHS fulfill and the general practitioner team model perfect.ObjectivesIn order to develop the general practitioner team, to definite the content of community nursing in general practitioner team, and lay bases for the government to make decisions on nursing arrangement and examinition program, perfect the reimbursement mechanism of general practitioner team, meet the residents'different demands of the health services, promote CHS fulfill.ContentsThe research focuses on the following several aspects:(1) learn more about the concent of general practitioner team. (2) learn more about the community nursing services in general practitioner team. (3) The content of community nursing services in general practitioner team and how to identify the scope of the nursing services item.MethodsThree CHS centers are selected according to their geography locations and stratified random. We choose all teams in 3 CHS centers. We collect all team members'service items and quantities, then classify them to find out the results. And for identifying the scope of community basic services items, groups interview and delphi counsel are adopted. The main topics of interview and counsel are: the definition of community nursing services in general practitioner team, how to identify the scope of each service item and the reasons. Finally, take frequency statistic on the interview results.ResultsBy analyzing the community nursing services content of all the teams and the result of groups interview and delphi counsel, 3 classes, 120 service items can be defined.The community nursing services in general practitioner team can be divided into three classes: basic nursing services, expansible nursing services, and non-fit nursing services. Among 120 service items, 51 items can be considered as basic nursing services: 39as expansible nursing services: 30 as non-fit nursing services.The basic package that was defined accords with the residents'needs of community nursing services and may satisfy their demands of the basic health services. The residents'needs of community nursing services will change accordding to the residents'incoming level and society progress, which demand community nurses expand suitable nursing service items positive to meet the advanced need of residents.Innovative points of the researchThe study is on the content of community nursing services in general practitioner team. There is few report about that. The classification on the items of comminity nursing service is studied with quantity and quality. The last definition of nursing service is studied with delphi counsel. We can get the most distinct result with the method which breaks the quantily analysis limit. This research results are accordant with the demand of the resident's, which makes the study full of practical merits. In order to regulate the contents of CHS and lay bases to perfect the reimbursement mechanism of the general practitioner team model and meet the residents'different demands of the health services.