Research On The Implementation Status Of Family Doctor Contract Services In Urban Communities In Urumqi

Objective:Through a comprehensive analysis of the current status of implementation of family doctor contract services in Urumqi,problems are found and suggestions and strategies for improving the family doctor contract service system are provided.Methods:Based on literature research,from May to September 2019,in-depth interviews were conducted with 256 family doctor team members,786 community contracted residents and 1244 unsigned residents in 12 community health service centers in 3 jurisdictions of Urumqi Questionnaire survey,statistical description using mean ± standard deviation,composition ratio and other indicators analysis,hypothesis test using t test,single factor analysis of variance,chi square test and other methods,influencing factors analysis using binary logistic and ordered Probit model and other methods In multiple regression analysis,P <0.05 was considered statistically significant.Results: 1)Urumqi's primary medical institutions form a total of 687 family doctor teams and 115 three-star teams.According to the service standard of 2,000 people,there is still a gap between the current team configuration and the need to achieve comprehensive coverage.2)The overall satisfaction of family doctor team members in signing service work was(3.72± 0.67),and professional titles and monthly income were factors that affected family doctor satisfaction level(P<0.05).3)72% of contracted residents signed separately after referring to a doctor.Contracted residents have low utilization rates of appointment and referral services,which are 30.6% and 1.7%,respectively.The overall satisfaction of contracted services is(3.82±0.62).The variables that have a significant impact on the satisfaction of contracted services are: age,month Income and education(P<0.05).4)44.9% of the residents who did not sign a contract expressed their willingness to sign a contract,43.5% of the residents who did not want to sign a contract or had not yet made a decision whether to sign a contract did not understand the family doctor signing service,and 30.2% of theresidents provided to members of the family doctor team There is no demand for services,and 15.8% of residents are members of the family doctor team who do not trust them.5)The services that community residents need are in front of basic public health services(87.95%),health assessments(86.91%),chronic illness prescriptions(84.59%),and family medical services(beds,special care,etc.)(81.58%)Four services;three services with large differences in supply and demand are home medical services(beds,special care,etc.),rational medication,chronic illness long-term prescription.6)Members of the family doctor team and community residents believe that the mainly difficulties in operating the family doctor contract service system are inadequate publicity,lack of hardware facilities,insufficient staffing,low quality of contracted services,and insufficient policy support.Conclusion: The establishment and service model of the family doctor team in Urumqi make full use of the limited medical resources to better serve the residents of the community;however,the establishment of the team is insufficient,the incentive assessment system for members of the family doctor team is incomplete,and the residents' recognition of contracted services Insufficient knowledge and inconsistent supply and demand of contracted service contents affect the further implementation of contracted services.The government and relevant departments should provide policy and system guarantees to further effectively implement the family doctor contract service system through measures such as strengthening the formation of the family doctor team,perfecting the performance evaluation system,and vigorously promoting the improvement of residents 'awareness.