本文選題：家庭醫(yī)生式服務(wù) + 現(xiàn)狀　； 參考：《中國地質(zhì)大學(xué)（北京）》2014年碩士論文

【摘要】：2010年北京市率先在試點地區(qū)探索家庭醫(yī)生式服務(wù)。方莊社區(qū)衛(wèi)生服務(wù)中心2010年成為北京市家庭醫(yī)生式服務(wù)的首批試點單位，以15個居委會為基點建立了15支家庭醫(yī)生式服務(wù)團(tuán)隊，簽約居民31816人。三年以來隨著工作的開展人力資源相對不足、服務(wù)能力離社區(qū)居民期望還存在差距等一些問題逐漸顯現(xiàn)出來。這些問題在上海、成都等其他地區(qū)家庭醫(yī)生式服務(wù)實施過程中也有所反映。 本文通過文獻(xiàn)研究對國內(nèi)外家庭醫(yī)生模式研究情況進(jìn)行了梳理，國外的家庭醫(yī)生服務(wù)大多是建立在按人頭預(yù)付及家庭醫(yī)生首診制基礎(chǔ)之上的，而國內(nèi)的研究多是集中在家庭醫(yī)生式服務(wù)開展情況和存在問題的分析，對于家庭醫(yī)生式服務(wù)模式的研究較少。本次以北京豐臺方莊社區(qū)衛(wèi)生服務(wù)中心為研究主體，通過隨機(jī)抽樣的方法，對方莊社區(qū)300名居民進(jìn)行問卷調(diào)查，獲知其對家庭醫(yī)生式服務(wù)的知曉情況、需求、滿意度和利用度。對服務(wù)團(tuán)隊43名主要成員問卷調(diào)查，獲得家庭醫(yī)生式服務(wù)提供量、培訓(xùn)需求、職業(yè)發(fā)展?jié)M意度等。以小組訪談的形式對方莊社區(qū)街道辦事處和居委會負(fù)責(zé)人進(jìn)行訪談，了解其對此項工作開展的意見和建議。對服務(wù)團(tuán)隊5名總隊長進(jìn)行訪談，了解實施過程中遇到的主要問題及想法。 通過對結(jié)果的統(tǒng)計分析，結(jié)合公共管理相關(guān)理論，，分析出現(xiàn)有服務(wù)模式存在組織結(jié)構(gòu)不完善、人員不足、缺乏配套運行機(jī)制以及信息化程度不高的問題。通過分析社區(qū)衛(wèi)生服務(wù)核心競爭力，從調(diào)整組織結(jié)構(gòu)、建設(shè)規(guī)范的家庭醫(yī)生式服務(wù)診療流程、完善機(jī)制建設(shè)、建立配套保障四方面構(gòu)建了方莊家庭醫(yī)生式服務(wù)模式。 該模式符合方莊社區(qū)衛(wèi)生服務(wù)中心自身發(fā)展特點，使醫(yī)生和簽約居民之間形成相對固定的服務(wù)關(guān)系，建立了有序就醫(yī)的診療秩序，對改善目前醫(yī)患關(guān)系提供了有效的措施，突出了社區(qū)衛(wèi)生服務(wù)的核心競爭力,將有力提高家庭醫(yī)生的服務(wù)能力和對簽約居民的健康管理水平。同時，由于我國家庭醫(yī)生式服務(wù)尚處于起步階段，是社區(qū)衛(wèi)生服務(wù)發(fā)展的新生事物，相關(guān)的管理體系、運行機(jī)制和政策法規(guī)也在不斷的完善和修訂中。本次研究對家庭醫(yī)生式服務(wù)這項惠民措施進(jìn)一步扎實推進(jìn)提出的相關(guān)建議將對其他地區(qū)類似服務(wù)模式的構(gòu)建產(chǎn)生一定借鑒作用。
[Abstract]:In 2010, Beijing was the first to explore family doctor service in the pilot area. The Fangzhuang community health service center was the first pilot unit of family doctor service in Beijing in 2010, and 15 family doctor service teams were set up on the basis of the 15 neighborhood committees, and 31816 people were signed. In the past three years, the human resources were carried out with the work. Some problems, such as the gap between the service capacity and the community's expectations, are emerging. These problems are also reflected in the implementation of family doctor services in other areas, such as Shanghai, Chengdu and other areas.
In this paper, the study of family doctors at home and abroad is combed through literature research. Most of the family doctor services abroad are based on the prepayment and the family doctor's first consultation, while the domestic research is concentrated on the analysis of the situation and problems of the family doctor service and the family doctor service. The study was less. This time, taking the Fengtai Fangzhuang community health service center in Fengtai, Beijing as the research subject, a questionnaire survey was conducted on 300 residents in Fangzhuang community by random sampling, and the knowledge, demand, satisfaction and utilization of the family doctor service were obtained. The questionnaire survey on the 43 main members of the service team was obtained. In the form of a group interview, interviews were conducted between the District Office of the Zhuang community and the head of the neighborhood committee to understand their opinions and suggestions on the work. The main problems and ideas encountered in the implementation of the service team were interviewed by the 5 general captain of the service team.
Through the analysis of the results and the theory of public management, this paper analyzes the problems of imperfect organization structure, lack of personnel, lack of supporting operation mechanism and the low level of information in the service mode. Through the analysis of the core competitiveness of community health service, the construction of a standardized family doctor service diagnosis is built from the structure of the organization. The family physician service mode in Fangzhuang has been constructed in four aspects: the treatment process, the improvement of mechanism and the establishment of supporting guarantee.
The model conforms to the development characteristics of Fangzhuang community health service center, and makes a relatively fixed service relationship between doctors and contracted residents, establishes an orderly medical treatment order, provides effective measures to improve the current doctor-patient relationship, highlights the core competitiveness of community health services, and will effectively improve the service of family doctors. At the same time, as Chinese family doctor service is still in its infancy, it is a new thing in the development of community health service. The related management system, operation mechanism and policy and regulations are also being perfected and revised. This study further studies the benefits of family doctor service. Pushing forward the relevant suggestions will provide some reference for the construction of similar service models in other regions.
【學(xué)位授予單位】：中國地質(zhì)大學(xué)（北京）
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R197.6

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