| ObjectiveThe family doctor service contract(FDSC)is a new demand due to disease and death spectrum gradually changing to the new demand of chronic non communicable diseases and an important way to protect the health of the masses.And the team is the main form of FDSC.The research team from the domestic development and FDSC performance assessment of the status,to study through qualitative and quantitative methods of the establishment of Guangdong Province general team of family physicians a set of practical and has high validity and reliability of the performance evaluation index system to improve the performance of contracted services team family the doctor type contract service standardization,scientific level,and to test the scientific team of family physicians signing service performance evaluation index system and operability,provide some methodological basis and suggestions for future general team of family doctor service contract performance appraisal practice.MethodsIn this study,we use the "structure-process-structure",the key performance index method,the expert consultation method and the rank sum ratio method to establish the performance appraisal index system of FDSC in Guangdong province.This paper makes an empirical study on the performance evaluation index system of Guangdong province,Guangzhou,Shenzhen,Zhuhai and Zhongshan,and collects41 general teams as the empirical research samples in the four places.Different types of general-level family doctor-type contract service performance appraisal,testingGuangdong Province,general service team performance evaluation index system of scientific and operational,in order to further improve the Guangdong Province,the general team of FDSC to improve its services Efficiency and improve its quality of service.Results(1)After two rounds of expert consultation,this study established a set of three primary indicators,16 secondary indicators and 46 three indicators of Guangdong Province,the general team of family doctor contract service performance evaluation index system.The three primary indicators are F1 "service basis",F2 "service process and quality" and F3 "service effect",corresponding to the weight of 0.3179,0.3488 and 0.3333.(2)Empirical research,due to the current general team did not carry out the relevant work and the existing data cannot be statistics reasons,there are five three indicators cannot be collected,the weight of the performance appraisal system weight of 8.1%.(3)The status of family doctor contract service,the general practitioner is equipped with more adequate,the number of general practitioners per million population reached 3.15 ± 2.47,the median is 2.57;only 26.83% of the general team independent of public health the average contract for the general team is 53.49% ±24.53%,the minimum is 12.00% and the maximum is 99.00%.The 51.22%contracted population of the general team is mainly composed of household residents.(4)The performance evaluation results,the management model,the type of organization,the location of institutions,whether the income and expenditure of two lines management is the overall situation of the overall situation of qualitative evaluation of the impact of factors;"service process and quality" and "service effect",the qualitative evaluation results have an impact on the qualitative evaluation results of the overall situation,and the "service process and quality" is highly correlated with the overall situation.(5)through the expert interview on the Guangdong Province family doctor contracted service performance evaluation of the status quo qualitative research,the result is on the form of signing,experts have divergent views,but that the whole team to provide services in the form of team is necessary;The backwardness of theinformation system hinders the development of the performance evaluation of the family doctor contract service.The performance evaluation index of certain family doctor contract service contracted service provided by the existing government is not feasible.Conclusions(1)The performance evaluation index system of family doctor contract service in Guangdong province is basically covered by the whole content of family doctor contract service,which is effective and credible,and can be fully reflected in the whole team level.The performance of the contracted services for the future implementation of the Guangdong Province,the implementation of family doctors contracted services to provide valuable experience.(2)Currently in Guangdong Province,the implementation of hospital management,there is no implementation of the income and expenditure of two lines,the work site is located in the city's general team,the family doctor contract service performance evaluation results are better.(3)At present,the government puts forward to some of the family doctor type signing service performance evaluation indicators do not have operability,at the same time lag of grassroots medical institutions information system hindered the family doctor sign type service performance evaluation.Suggestion(1)improve the family doctor-type contract service incentive mechanism,the implementation of family physician contract service fees,enhance the enthusiasm of the contract serviceGuangdong Province should be in the preparation of planning,personnel hiring,title promotion awards and other aspects of the grass-roots dependence on the structure of the tilt,the lack of grass-roots medical institutions into the ranks of all levels of government personnel to introduce policy,and enhance the attractiveness of primary health care institutions.According to the results of this study,it is recommended that you do not carry out the signing service for family doctors through the implementation of the contract award.You should implement the signing service fee of the family doctor as soon as possible and pay the contract fee for the family physician through reasonable and scientific performance appraisal,increase the income of the primary medical personnel,To mobilize the work of enthusiasm.At present,there is no prefecture-level city in Guangdong Province,theimplementation of family service contract fees,it is recommended that the city can learn the practice of Hangzhou,Wuhan and Ningbo,in accordance with the social health insurance fund,basic public health services and contracted residents to pay the way to implement the family doctor Contract service fees,the amount of contract service fees can refer to the domestic excellent practice.(2)to strengthen the family doctor contract service performance appraisal,to avoid the occurrence of formal signingGovernments at all levels should strengthen the performance of family doctor contracted service performance,from the assessment of the rationality of indicators,operability to improve the efficiency of performance appraisal.The focus of performance appraisal Do not stay in the contract situation,to sign and perform a dynamic combination of assessment at the same time to avoid the blind pursuit of high contract rate and ignore the service itself.At the same time,the establishment of a regular assessment mechanism,regular institutions and general team to carry out family doctor contract service performance appraisal,you can invite representatives of residents to participate in supervision,and the timely publication of the results of the assessment,the formation of the role of public opinion.(3)to strengthen the contract service technical support,the establishment of family-based contract for the information service platformTo build a platform for family physician contracting services to achieve the signing of residents health records,basic public health services and basic medical services linkage,to avoid the barriers due to information platform to form a number of "information island." At the same time,according to the requirements of family doctor contract service performance assessment,to meet the needs of the work on the basis of information technology platform to serve the performance appraisal to carry out,can quickly and accurately get the family doctor contract service performance assessment required Of the indicator results.Combined with "Internet+" technology,the use of a variety of Internet ways to build a contracted residents and the whole team of communication platform for the residents to provide information consultation,interactive communication,patient feedback to facilitate. |
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