Problems and Countermeasures in the Development of Contracted Family Doctor Services in Achieving Healthy China Goals

doi:10.12114/j.issn.1007-9572.2019.00.352

Abstract

Abstract: As one important measure for achieving the medical reform launched in 2009 in China，the delivery of contracted family doctor services plays a key role in the realization of initial consultation in primary care，promotion of hierarchical medical system，and transformation of healthcare delivery models.On the basis of the reviewing of the development and related literature of contracted family doctor services in China，from three perspectives（supplier，demander and implementation mechanism），we analyzed the following major problems existing in the development of the services during the implementation of the Healthy China Initiative：insufficient quantity and inadequate quality of primary healthcare resources，residents' unsatisfactory acceptance of contracted family doctor services，inadequate growing and training mechanisms for general practitioners（GPs），lack of performance assessment and incentive mechanisms for GPs，insufficient strength of medical insurance payment mechanism in guiding patients' healthcare seeking in primary care，and imperfect publicizing mechanism and information construction for contracted family doctor services.Accordingly，we put forward the following suggestions：further enhancing the service capacities of primary healthcare institutions，improving the policy support for the implementation of contracted family doctor services，establishing and improving the performance assessment and incentive mechanisms for GPs，and actively promoting the development of Internet-based community healthcare.

Key words: Contracted family doctor services, Hierarchical medical system, Community health services, Healthy China, Development process, Present situation, Problem, Countermeasure

摘要： 家庭医生签约服务是我国新医改的重要任务之一，对实现基层首诊、推进分级诊疗、转变医疗卫生服务模式具有重要意义。本文以健康中国为背景，通过梳理我国家庭医生签约服务的发展历程和相关文献，从家庭医生签约服务的供方、需方及运行机制3个角度，分析其在发展过程中存在的主要问题，包括：基层医疗卫生资源数量及质量不高，居民对签约服务的接受度不高，全科医生培养与培训机制不健全，考核激励机制欠缺，医保支付机制导向性不强，沟通宣传机制和信息化建设不完善。建议进一步提升基层医疗卫生机构的服务能力，完善签约服务政策支持，建立健全考核激励机制，积极推进“互联网+社区医疗”。

关键词: 家庭医生签约服务, 分级诊疗, 社区卫生服务, 健康中国, 发展历程, 现状, 问题, 对策

FU Yingjie,WANG Jian,YU Lexin, et al. Problems and Countermeasures in the Development of Contracted Family Doctor Services in Achieving Healthy China Goals　[J]. Chinese General Practice, 2019, 22(19): 2296-2300. DOI: 10.12114/j.issn.1007-9572.2019.00.352.
付英杰,王健,俞乐欣等. 健康中国背景下家庭医生签约服务发展中的问题与对策研究[J]. 中国全科医学, 2019, 22(19): 2296-2300. DOI: 10.12114/j.issn.1007-9572.2019.00.352.

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