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目的探讨分析家庭医师签约服务的作用,为建立科学、可持续的新型医疗系统提供理论依据。方法选取2015年8月至2016年8月本地区200名签约家庭医师的居民作为观察组,同期选择200名未签约居民作为对照组,统计比较两组居民的首诊率、定点就诊率、预约门诊率、医疗服务满意度、医保指标情况以及改革前、后医师收入水平(平均工资、平均奖金)。结果观察组居民首诊率、定点就诊率以及医疗服务满意度均显著高于对照组,预约门诊率显著低于对照组,差异均有统计学意义(均P<0.05);观察组居民每次就诊费用与药占比均显著低于对照组,差异均有统计学意义(均P<0.05);改革后,医师平均工资、平均奖金均显著高于改革前,差异均有统计学意义(均P<0.05)。结论家庭医师签约服务关乎民众健康、安全,能够有效利用有限的医疗服务资源,控制和降低医疗费用和负担,引导居民有效、有序就诊;同时还能够促进医师收入水平上升,充分调动其诊治的积极性,从而提升医疗服务水平。
Objective To explore the role of family physician signing service and to provide a theoretical basis for establishing a scientific and sustainable new type of medical system. Methods From August 2015 to August 2016, 200 residents with contracted family doctors in this area were selected as the observation group and 200 unsigned residents were selected as the control group. The first visit rate, the fixed-point visit rate and the appointment rate were compared between the two groups Outpatient rate, satisfaction with medical services, health insurance indicators as well as the level of physicians’ income (average salary, average bonus) before and after the reform. Results Residents in the observation group had significantly higher first visit rate, fixed-point visit rate and satisfaction with medical services than those in the control group, and the outpatient appointment rate was significantly lower than that of the control group (all P <0.05) (Both P <0.05). After the reform, the average salary and average bonus of physicians were significantly higher than those of the control group (both P <0.05), both of which were statistically significant P <0.05). Conclusions The signing service of family physicians is related to people’s health and safety. It can effectively utilize limited medical service resources, control and reduce medical expenses and burdens, and guide residents to seek effective and orderly treatment. At the same time, it can also promote doctors’ income level and fully mobilize their diagnosis and treatment Enthusiasm, thereby enhancing the level of medical services.