摘要
目的评价上海市“1+1+1”医疗机构组合签约服务对分级诊疗的影响。方法通过纵向比较户籍签约人口签约前后、横向比较户籍签约人口和户籍非签约人口前往不同医疗机构门诊就诊的行为特征,获取“1+1+1”签约服务对户籍人口就医行为的影响,对分级诊疗的引导成效。结果签约人口有社区卫生服务中心门诊就诊经历的占比(92.1%)明显高于非签约人口(48.0%),前往社区医院就诊的人次占比(72.1%)明显高于非签约人口(42.1%);签约前后,签约人口在不同医疗机构内就诊人次占比变化较小;在签约后,签约人口49.8%的就诊发生在组合内的医疗机构,其中,79.3%的就诊人次流向社区卫生服务中心。结论健全医疗机构科室设置,提高分级诊疗重点管理人群签约率;加强分级诊疗宣传,引导户籍人口理性就医;提升基层全科医生质量,增强签约服务吸引力。
Objective To evaluate the impact of“1+1+1”medical institution combination signing project on the policy of hierarchical diagnosis and treatment. Methods By comparing vertically and horizontally the behavior characteristics of signed residents and unsigned residents before and after signing the contract,the effects of “1+1+1”signing project on the behavior of signed residents and on the hierarchical diagnosis and treatment were evaluated. Results The proportion of the signed residents with outpatient experience in community health service centers ( 92.1%) was significantly higher than that of the unsigned residents ( 48.0%),and the proportion of the signed residents visiting community hospitals ( 72.1%) was also significantly higher than that of the unsigned residents ( 42.1%). Before and after the signing of the contract,the proportion of the signed residents visiting different medical institutions changed slightly. After the signing,49.8% of the signed residents visited the medical institutions within the combination,of which 79.3% went to community health service centers. Conclusion It is neces-sary to improve the setting of departments of medical institutions so as to increase the signing rate of key management objects of the policy of hierarchical diagnosis and treatment;to strengthen the policy publicity so as to guide local residents to seek medical treatment rationally;and to improve the quality of the grass-roots general practition- ers so as to enhance the attractiveness of the signing project.
作者
刘嘉祯
田文琪
张绍禹
谢桦
曹剑峰
崔欣
LIU Jiazhen;TIAN Wenqi;ZHANG Shaoyu;XIE Hua;CAO Jianfeng;CUI Xin(Shanghai Health Information Center,Shanghai 200040)
出处
《解放军医院管理杂志》
2019年第8期715-718,共4页
Hospital Administration Journal of Chinese People's Liberation Army
基金
上海市卫生和计划生育委员会科研课题面上项目(201440348)
上海市卫生和计划生育委员会卫生政策自选申报课题(2018HP30)
上海市经信委信息化发展专项资金项目(201701047)
关键词
签约服务
分级诊疗
家庭医生
medical institution combination signing project
hierarchical diagnosis and treatment
family physician
