Integrated Service Model and Practice Dilemma of County-level Family Doctor Team under the Compact County-level Medical Consortium：Based on the Critical Incident Technique

doi:10.12114/j.issn.1007-9572.2024.0385

Chinese General Practice

1.School of Medicine and Health Management，Tongji Medical College，Huazhong University of Science and Technology，430030 Wuhan，China；2.Jiaxing University College of Medicine，Jiaxing 314001，China；3.Research Center of Hospital Management and Development，Tongji Medical College，Huazhong University of Science and Technology，430030 Wuhan，China

Received:2024-05-17 Revised:2024-09-04 Accepted:2024-09-10
Contact: TAO Hongbing，Professor/Doctoral supervisor；E-mail：hhbtao@hust.edu.cn

紧密型县域医共体下家庭医生团队整合服务模式研究：基于关键事件技术法

1.430030 湖北省武汉市，华中科技大学同济医学院医药卫生管理学院；2.314001 浙江省嘉兴市，嘉兴大学医学院；3.430030 湖北省武汉市，华中科技大学同济医学院医院管理与发展研究中心

通讯作者: 陶红兵，教授 / 博士生导师；E-mail：hhbtao@hust.edu.cn
基金资助:
国家自然科学基金面上项目（72074093）

Abstract

Abstract: Background　Intensive county medical community plays an important role in improving the ability of primary medical service. As its service body，family doctor team provides quality soil for integrated service development. However，previous studies lack exploration and summary of relevant service models. Objective　To summarize the integrated service model of family doctor team in the compact county medical community. Methods　From July 2023 to November 2023，62 family doctor team members in Dancheng City，Anyang City and Gongyi City of Henan Province were interviewed about integrated service practice by using semi-structured interview and key event technology. Results　Four themes of integrated services are analyzed and further refined，they were subject，content，process，and obstacles of integrated services. Drawing on the physiological structure of "squid"，this paper proposed "squid model" to describe the integrated service mode of the county familydoctor team，emphasizing the core command role of the county medical community，the coordinating role of the family doctor management office，and the service antenna function of the county and village third-level family doctor team and village doctor. Conclusion　"Squid model" provides an intuitive framework for understanding and optimizing this service model. The integrated service model of county family doctor team shows the characteristics of diversified subject participation and all-round service content integration，but it still faces certain obstacles.

Key words: Family physician team, Integrated service mode, Compact county-level medical consortium, Critical event technology, Qualitative research

摘要： 背景　紧密型县域医共体在提升基层医疗服务能力中扮演重要角色，家庭医生团队作为其服务主体为整合服务开展提供优质土壤，但既往研究缺乏对相关服务模式的探索和总结。目的　了解紧密型县域医共体家庭医生团队的整合服务模式。方法　于2023年7—11月，基于关键事件技术法，目的性选取河南省郸城市、安阳市、巩义市的62名家庭医生团队成员，围绕整合服务实践对其进行半结构化访谈。结果　对访谈资料进行分析，得出整合服务的4个主题，分别为整合服务主体、整合服务内容、整合服务过程、整合服务障碍。借鉴“鱿鱼”生理构造，提出“鱿鱼模式”，以形象描述县域家庭医生团队的整合服务模式。该模式中，强调县域医共体的核心指挥作用，家庭医生办公室的协调角色，以及县乡村三级家庭医生团队和乡村医生的服务触角功能。结论　“鱿鱼模式”为理解和优化该服务模式提供了直观框架，县域家庭医生团队的整合服务模式呈现多元化主体参与、全方位服务内容整合的特点，但仍面临一定阻碍。

关键词: 家庭医生团队, 整合服务模式, 紧密型县域医共体, 关键事件技术, 质性研究

CLC Number:

R 197

DAI Gaolanxin,YIN Gang,$authoret .al. Integrated Service Model and Practice Dilemma of County-level Family Doctor Team under the Compact County-level Medical Consortium：Based on the Critical Incident Technique[J]. Chinese General Practice. DOI: 10.12114/j.issn.1007-9572.2024.0385.
代高岚歆,尹刚,李浩,等. 紧密型县域医共体下家庭医生团队整合服务模式研究：基于关键事件技术法[J]. 中国全科医学. DOI: 10.12114/j.issn.1007-9572.2024.0385.

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