Study On The Status Quo And Implementation Effect Of Contract Services Of Family Doctors In Typical Case Area

Objective:Based on the theory of contract services of family doctors and the summary of domestic and foreign practice models,understand the policy measures and operational mechanism of contract services of family doctors in typical case areas,and apply the established contract services of family doctors evaluation index table to analyze the effect of contract services of family doctors implementation.As well as the existing problems,and put forward the policy recommendations to improve the contract services of family doctors,provide reference and reference for analyzing the effect of contract services of family doctors policy and improving the system construction.Contents:Analyze the status quo of contract services of family doctors in typical cases;Evaluate the implementation effect of contract services of family doctors in typical cases;Propose policy recommendation to perfect contract services of family doctors.Methods:This study uses the literature research method to sort out the goals and connotations of the contract services of family doctors policy;Investigate the typical case area family through the field survey using questionnaires,personal in-depth interviews and focus group discussions to get the status quo and effect of contract services of family doctors;Statistical analysis and comparative analysis method were used to describe and analyze the implementation effect of contract services of family doctors in typical case areas.Outcome:1.Typical case regional contract services of family doctors statusThe corresponding contract services of family doctors policies have been issued in all regions,including how to promote contracting services,implementation opinions of contracting services,and performance evaluation of corresponding contracting services.A team-based signing service entity has been established.The team is mainly a family doctor,and is equipped with a nurse and a public health personnel.The insured residents who live in the area are basically the target of the contract,and the key groups are the main contractors.Covering basic medical services,basic public health services,and personalized health management services,the types of service packages are broadly divided into two parts:unpaid and paid.Fundraising,assessment and incentive mechanisms for f contract services of family doctors have been basically established.2.The overall overview,policy implementation and target effect of contract services of family doctors in typical case areasAccording to the contract services of family doctors evaluation indicator,the effect of the contract services of family doctors in the typical case area is evaluated.The main body and content of the contract services of family doctors in all regions are basically available;The ten key groups have the proportion of suitable contracting services,and the content of contracting services is relatively complete;the fundraising mechanism is basically established,and the per capita contracted service fee standard and the contracted service fee financing channel are relatively reasonable;Incentives and technical guarantees are basically available in all regions;Local governments have basically established a contract services of family doctors management platform and are constantly improving the platform construction,and have established a family doctor team work system and developed a contract services of family doctors team assessment and the plan for internal assessment and assessment;the signing and renewal of contract services of family doctors is better;The capacity of primary health care institutions is continuously enhanced;The utilization of contracted services and health management have certain effects;The degree of residents understand contracting services is partial and residents are satisfied with contracting services;Grassroots medical staffs'satisfaction with contracting services is average.Conclusion:This study is based on the connotation and policy objectives of contract services of family doctors,and applies the established contract services of family doctors evaluation index table.Based on this,the typical case areas are Zhejiang Dongyang City,Zhejiang Deqing County,Anhui Baohe District,Anhui Province.City County,Sichuan Wuhou District,and Sichuan Xinjin County conducted research and described and compared the status and effects of the signing service.The research and comparison of the implementation status and effects of the contract service were carried out.The following conclusions can be drawn for reference in other regions:the contracting parties and contents of contract services of family doctors are basically available;The incentive mechanism for contract services of family doctors has been established in various places,but its role is limited;the county medical community has a certain role in promoting the contract services of family doctors;the contract services of family doctors promotes the improvement of primary medical service capacity and improves the health status of residents;the process of informatization construction slows down the development of contract services of family doctors;the lack of human resources and capacity at the grassroots level is still a constraint to the development of contract services of family doctors;the awareness of contract services of family doctors needs to be further strengthened.In order to further promote the contract services of family doctors,we should improve the income and assessment incentive mechanism of the family doctor team;promoting the supportive role of the close medical community in signing services for family doctors;strengthen the informatization construction of contract service to improve service efficiency;increase the training of general practitioners,improve the service capacity of primary health care institutions;Enhance the understanding of both the supply and demand sides of the contract service.