Contracted Family Doctor Service Models Leading to Healthy China：a Comparative Study

doi:10.12114/j.issn.1007-9572.2020.00.263

Abstract

Abstract: The contracted family doctor service is the focus of China's current medical and health reform. It is an important way to implement hierarchical diagnosis and treatment，achieve rational use of medical resources，and safeguard the health of people. It is also the cornerstone of achieving the Healthy China 2030 Strategy. This paper analyzed six service models of family doctors in China，including "1+1+1" service model in Shanghai，"Three-in-one" service model in Xiamen，family-based integrated medical care service model in Hangzhou，"Prepayment by Per Capita Budget" service model in Dingyuan County，"Basic Package + Individual Package" service model in Dafeng District of Yancheng，and service model in Luohu of Shenzhen. Then this paper compares the subject，method，content，form of the medical treatment alliance，payment of contracted service fees，characteristics of medical insurance payment，analyzes the policy logic and the bottlenecks in the current contracted family doctor service models，and proposed two representative ideal models in urban and rural areas in order to provide reference and inspiration for promoting contracted family doctor services in various areas.

Key words: Contracted family doctor services, Service model, Hierarchical diagnosis and treatment

摘要： 家庭医生签约服务是我国当前医疗卫生改革工作的重点，是实施分级诊疗、合理利用医疗资源、保障群众健康的重要途径，也是实现健康中国2030战略的基石。本文通过剖析上海市“1+1+1”签约服务模式、厦门市“三师共管”签约服务模式、杭州市家庭型医养护一体化服务、定远县“按人头总额预付”签约服务模式、盐城大丰区“基础包+个性包”签约服务模式、深圳罗湖模式6种国内特色家庭医生签约模式，从签约服务的主体、方式、内容、医联体的形式、签约服务费用的支付、医保支付的特点等方面进行了对比，并分析了政策逻辑和当前家庭医生签约服务存在的瓶颈，提出城市和乡村两种具有代表性的理想模式，希望为各地推进家庭医生签约服务提供借鉴和启示。

关键词: 家庭医生签约服务, 服务模式, 分级诊疗

LIU Rui,YANG Danhong,WU Huanyun, et al. Contracted Family Doctor Service Models Leading to Healthy China：a Comparative Study　[J]. Chinese General Practice, 2020, 23(25): 3139-3145. DOI: 10.12114/j.issn.1007-9572.2020.00.263.
刘锐,杨旦红,吴欢云等. 通向健康中国的家庭医生签约服务模式比较研究[J]. 中国全科医学, 2020, 23(25): 3139-3145. DOI: 10.12114/j.issn.1007-9572.2020.00.263.

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