Research On The Construction Of Family Doctor Team Competency Model

Background: Implementing family doctor contracting service is a rocker to enhance China’s primary health care service capacity and the one of the important measures for the development of health services in China.As a provider of contracting services,the family doctor team assumes the role of resident health "gatekeeper".Family doctor team competency is the key to the effective implementation of contract service.Due to the late start of the family doctor system in China,family Doctor Service Team is still in the construction stage and not have a unified and standard model,so the training,assessment and other standards of team members are not systematic and standardized.Therefore,it is an important task to establish an objective and feasible competency model of family doctors based on the reality of the contracted services of family doctors in China.Objective: To construct the competency model framework of family doctor team,this study based on a comprehensive analysis of the status quo of the contracted services of family doctors in China,combined expert advice,amended the Model through Practical Investigation.To provide the basis for guiding the future development of family doctor team and the training of team talents in China.Method:1.Comprehensive literature research and work analysis provide materials,taking into account the characteristics of family doctors’ contracting services,and refer to the domestic mature general practitioners,nurses and other related primary medical occupation job competency models to form a preliminary model framework.2.The theoretical framework is further modified,increased and decreased through the two rounds of Delphi method,so the family doctor team competency model is improved.3.A typical survey was conducted in each of the northern,central and southern parts of Anhui Province to examine the reliability and validity of the model and to further revise and test the competency model.Results: Based on theoretical analysis,Delphi method and on-site investigation,the results obtained are as follows:1.Based on the relevant literature and policy analysis,combined with the characteristics of family doctors’ contracting services,the preliminary framework of the model was selected,including 4 competency dimensions and 30 competency characteristics.2.The results of Delphi method: the positive coefficients of experts are 0.9 and 1,the expert coordination coefficient is 0.294 and 0.314,the expert authority coefficient is between 0.75 and 0.95,and the average is 0.87.After the two rounds of Delphi,4 competency dimensions and 26 competency feature entries were retained.3.Model revision and testing: A total of 12 medical institutions in three cities were involved,involving 299 members of 105 family doctor teams,and 276 valid questionnaires,with an effective rate of 92.31%.Exploratory factor analysis extracted 4 common factors and the cumulative contribution rate was 70.674%;the modified model had a total Cronbach α coefficient of 0.964,and the 4 dimensions Cronbach α coefficient was between 0.908 and 0.936,both higher than 0.9;the final model obtained included 4 competency dimensions and 25 competency feature entries.The self-evaluation score of the family doctor team was 102.19±15.05.The evaluation of the competency of the family doctor team members was generally good,and they believed that they were qualified for the current contract service.Through single factor analysis,academic qualifications,working years,and urban and rural institutions are related to the competency of the family doctor team,which can affect the competency of family doctor team.Conclusion: This study is based on a scientific and reliable method to build a family doctor team competency model,comprehensive reality,the model is universal.The construction of this model not only provides a reference for studying the selection,training,assessment and evaluation of the competence of the family doctor service team in the regional medical and health institutions,but also points the direction for the development of the family doctor service team in the future.The model still needs to be improved in continuous application.