Existing Circumstances Research Of “The Family Doctor Signing Service” System In Changji

Objective:To understand the community health service of “the family doctor signing service ” in Changji, Xinjiang,The construction of community health service system and the effect of key health services, to understand the community to carry out the health policy, the job satisfaction and the status of residents satisfaction. Analyzed the factors affecting of the satisfaction in order to provide a reference for the family physician contract system service model. Methods:Adopted the method of registration survey form, the data were collected were the human resources, infrastructure and key health services, with the 64 community health service organizations(include community health service center 6 and community health service station 58) in Changji in 2014.Adopted questionnaire survey method, to surveyed the satisfaction survey of the 303 community health service providers(Medical staff) job satisfaction and 2,225 community health service users(inhabitants) respectively. Statistical methods:(1) Used SPSS16.0 to analyze data.(2) The reliability of the index system was tested using Cronbach’s alpha and split-half reliability. The validity of the index system was analysed by factor analysis and correlation analysis.(3) The metering data was presented as means ± standard deviation(x ± s) for statistical description. A paired t-test was used to assess the significance of change between two groups and analysis of variance was used to assess the statistical significance of differences among multiple groups. The data were considered reliable when the correlation coefficient was 0.05(α = 0.05). Results:(1) The Government of the Changji attaches great importance to the development of community health service, but the allocation of health resources is not balanced, the lack of medical technical personnel, the family physician team building was slightly less, the residents health records filing rate is high, but the common chronic disease management need to further strengthen.(2) The average score of the overall satisfaction medical staff was 3.68 points. Medical staff of interpersonal relationship, leadership and management, working conditions, work itself, compensation and benefits, training and promotion of each factor score were 3.94, 3.80, 376, 3.73, 339, 3.43 points. including compensation and benefits, training and promotion were the lowest score.(3) The average score of the overall satisfaction residents was 4.01 points. Residents of hardware and environment, service projects, service process, service results of the satisfaction factors were 3.91, 4.03, 4.10, 4.06 points, including the hardware and the environment was the lowest score. Residents’ satisfaction with different characteristics were affected by nationality, age, occupation, income level that the impact were the larger and the impact of gender were the smaller.(4)“Family doctor signing service”in the thematic analysis,staff awareness of the system is higher and residents awareness of the system is lower. In willingness signed, the main reason is that the work increase the workload, it was Affected that staff engaged in contract work. The main reason for the impact of the signing of the residents is not understanding of the contract system, because the residents fear the impact of their medical care and medical technology quality. Most of the medical personnel believe that the contract service to save manpower, increase the appointment clinic; to promote two-way referral and management of chronic diseases; And can improve the proportion of the community’s first visit, improving the medical compliance of residents, closing relationship between doctors and patients. The staff is full of hope for the community health service development prospects. Most of the residents are satisfied with the service provided by the family physician team. The resident believes that the medical service provided by the family physician contract system is more rapid, timely and the chronic disease management and health follow-up are also satisfied. Conclusion: The government of Changji pays attention to community health work.The financial investment is slightly higher than the other city of Xinjiang. The basic of drug categories is not complete in the community health services, the first diagnosis and two-way referral system are not perfect. General practitioners, community nurses, doctors of traditional Chinese medicine there are shortage in the human resources, the team building of family physician is shortage. The utilization rate of resident health archives is not high. Therefore, it is suggested that the government should increase the financial investment, improve the basic medical system, increase the number of drugs and medical devices, and provide favorable policies to attract patients to doctoring in the community health service organizations. Improving the use of health records, it is good for in health management for residents. Improving the health literacy of residents, paying attention to the family doctor signing service system of publicity. Improving the capability and level of community health services in all its aspects, in order to residents to use the best, closest, most convenient health services.