[1]张天程,张丹丹,冯郑文,等.基于卫生系统宏观模型的北京市家庭医生式服务发展影响因素探索[J].医学信息,2021,34(16):15-18,24.[doi:10.3969/j.issn.1006-1959.2021.16.005]
　ZHANG Tian-cheng,ZHANG Dan-dan,FENG Zheng-wen,et al.Research on the Influencing Factors of the Development of Family Doctor Service in Beijing Based on the Macroscopic Model of the Health System[J].Medical Information,2021,34(16):15-18,24.[doi:10.3969/j.issn.1006-1959.2021.16.005]
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基于卫生系统宏观模型的北京市家庭医生式服务发展影响因素探索()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年16期
页码:
15-18,24
栏目:
出版日期:
2021-08-15

文章信息/Info

Title:
Research on the Influencing Factors of the Development of Family Doctor Service in Beijing Based on the Macroscopic Model of the Health System
文章编号:
1006-1959（2021）16-0015-05
作者:
张天程; 张丹丹; 冯郑文; 等
（1.首都医科大学全科医学与继续教育学院，北京 100069； 2.济宁医学院附属医院兖州院区健康管理中心，山东 济宁 272100）
Author(s):
ZHANG Tian-cheng; ZHANG Dan-dan; FENG Zheng-wen; et al.
(1.School of General Medicine and Continuing Education,Capital Medical University,Beijing 100069,China; 2.Yanzhou District Health Management Center,Affiliated Hospital of Jining Medical University,Jining 272100,Shandong,China)
关键词:
家庭医生式服务; 德尔菲法; 卫生系统宏观模型; 绩效考核; 激励机制
Keywords:
Family doctor service; Delphi method; Macroscopic model of health system;  Performance appraisal; Incentive mechanism
分类号:
R197.61
DOI:
10.3969/j.issn.1006-1959.2021.16.005
文献标志码:
A
摘要:
目的 探索影响北京市家庭医生式服务发展的关键因素，为其可持续发展提供建议。方法 基于卫生系统宏观模型，拟定影响北京市家庭医生式服务发展的影响因素列表。本研究遴选了28位专家进行德尔菲专家咨询，并通过分析两轮专家咨询结果中各指标的重要性评分位和变异系数，筛选出位列前10位的影响因素。结果 两轮专家函询表回收率分别为96.43%和92.86%，专家的权威系数为0.801。两轮评价指标重要性的专家协调系数分别为0.255和0.332（P＜0.05）。通过两轮专家咨询筛选出了全科医生收入、医保报销政策、全科医生数量等制约北京市家庭医生式服务发展的前10位影响因素。结论 卫生系统内部缺少合理的绩效考核与激励机制，卫生系统外部供方价值的补偿不足、医保报销政策向基层的倾斜不足以及居民的健康素养有待提高等问题，从根源上制约着家庭医生式服务的可持续发展。
Abstract:
Objective To explore the key factors affecting the development of family doctor service in Beijing, and provide suggestions for its sustainable development.Methods Based on the macroscopic model of the health system, a list of influencing factors affecting the development of family doctor service in Beijing was drawn up.In this study, 28 experts were selected for Delphi expert consultation, and the top 10 influencing factors were screened out by analyzing the importance scoring position and coefficient of variation of each indicator in the results of two rounds of expert consultation.Results The recovery rates of the two rounds of expert letter inquiries were 96.43% and 92.86%, and the expert’s authority coefficient was 0.801. The expert coordination coefficients of the two rounds of evaluation index importance were 0.255 and 0.332 respectively (P＜0.05).Through two rounds of expert consultation, the top 10 influencing factors such as the income of general practitioners, medical insurance reimbursement policies, and the number of general practitioners have been screened out that restrict the development of family doctor-style services in Beijing.Conclusion There is a lack of reasonable performance appraisal and incentive mechanisms within the health system, insufficient compensation for the value of external providers in the health system, inadequate inclination of medical insurance reimbursement policies to the grassroots, and problems such as the need to improve the health literacy of residents.The root cause restricts the sustainable development of family doctor service.

参考文献/References:

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更新日期/Last Update: 1900-01-01