中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
28期
3410-3412
,共3页
全科医生助理员%家庭医生制度%签约服务%效果评价
全科醫生助理員%傢庭醫生製度%籤約服務%效果評價
전과의생조리원%가정의생제도%첨약복무%효과평개
Assistants for general practitioners%Family doctor service system%Contractual services%Effect evaluation
目的：评价全科医生助理员参与家庭医生签约制服务的效果。方法选取2013、2014年潍坊社区常住居民分别作为A （n＝102378）、 B组（n＝102526）。其中A组无全科医生助理员参与，主要由潍坊社区卫生服务中心3个社区团队的6名全科医生在门诊过程中独立进行居民签约制服务； B组有全科医生助理员参与，来自本中心的6名全科医生助理员与A组全科医生一对一配对后进行居民签约制服务。比较两组居民的电子档案建档、双向转诊及筛查项目情况。结果 B组居民电子健康档案建档率〔37.13％（38068／102526）比20.56％（21051／102378）〕、双向转诊率〔0.11％（116／102526）比0.04％（39／102378）〕均高于A组，差异有统计学意义（P＜0.01）。 A组全科医生协同防保人员共计15人完成大肠癌筛查人数4436人，人均完成295.7人； B组全科医生助理员6人共完成大肠癌筛查人数4000人，人均完成666.6人。 A组完成65岁以上老年人体检2684人次，人均完成178.9人次； B组完成65岁以上老年人体检6263人次，人均完成1043.8人次。结论全科医生助理员对家庭医生签约制服务有促进作用，使服务模式运作更灵活，提高了全科团队的工作效率；另外可以使更多政府公益筛查项目在社区进行覆盖。
目的：評價全科醫生助理員參與傢庭醫生籤約製服務的效果。方法選取2013、2014年濰坊社區常住居民分彆作為A （n＝102378）、 B組（n＝102526）。其中A組無全科醫生助理員參與，主要由濰坊社區衛生服務中心3箇社區糰隊的6名全科醫生在門診過程中獨立進行居民籤約製服務； B組有全科醫生助理員參與，來自本中心的6名全科醫生助理員與A組全科醫生一對一配對後進行居民籤約製服務。比較兩組居民的電子檔案建檔、雙嚮轉診及篩查項目情況。結果 B組居民電子健康檔案建檔率〔37.13％（38068／102526）比20.56％（21051／102378）〕、雙嚮轉診率〔0.11％（116／102526）比0.04％（39／102378）〕均高于A組，差異有統計學意義（P＜0.01）。 A組全科醫生協同防保人員共計15人完成大腸癌篩查人數4436人，人均完成295.7人； B組全科醫生助理員6人共完成大腸癌篩查人數4000人，人均完成666.6人。 A組完成65歲以上老年人體檢2684人次，人均完成178.9人次； B組完成65歲以上老年人體檢6263人次，人均完成1043.8人次。結論全科醫生助理員對傢庭醫生籤約製服務有促進作用，使服務模式運作更靈活，提高瞭全科糰隊的工作效率；另外可以使更多政府公益篩查項目在社區進行覆蓋。
목적：평개전과의생조리원삼여가정의생첨약제복무적효과。방법선취2013、2014년유방사구상주거민분별작위A （n＝102378）、 B조（n＝102526）。기중A조무전과의생조리원삼여，주요유유방사구위생복무중심3개사구단대적6명전과의생재문진과정중독립진행거민첨약제복무； B조유전과의생조리원삼여，래자본중심적6명전과의생조리원여A조전과의생일대일배대후진행거민첨약제복무。비교량조거민적전자당안건당、쌍향전진급사사항목정황。결과 B조거민전자건강당안건당솔〔37.13％（38068／102526）비20.56％（21051／102378）〕、쌍향전진솔〔0.11％（116／102526）비0.04％（39／102378）〕균고우A조，차이유통계학의의（P＜0.01）。 A조전과의생협동방보인원공계15인완성대장암사사인수4436인，인균완성295.7인； B조전과의생조리원6인공완성대장암사사인수4000인，인균완성666.6인。 A조완성65세이상노년인체검2684인차，인균완성178.9인차； B조완성65세이상노년인체검6263인차，인균완성1043.8인차。결론전과의생조리원대가정의생첨약제복무유촉진작용，사복무모식운작경령활，제고료전과단대적공작효솔；령외가이사경다정부공익사사항목재사구진행복개。
Objective To evaluate the effect of assistants for general practitioners in family doctor service system.Methods In 2013 and 2014, we enrolled permanent residents of Weifang Community and divided them into group A (n=102 378) and group B (n=102 526) .In group A, no assistants for general practitioners were involved , and 6 practitioners of 3 community health teams of Weifang Community Health Service Center independently provided contractual services for residents during outpatient treatment; in group B , assistants for general practitioners were involved , and each of the same general practitioners of group A provided contractual services for residents with the help of one fixed assistant .Comparison was made between the two groups in electronic record establishment , two-way referral and screening items.Results Group B was higher (P<0.01) than group A in the rate of electronic health record establishment 〔37.13% (38 068/102 526) vs.20.56%(21 051/102 378)〕 and the rate of two-way referral 〔0.11% (116/102 526) vs.0.04% (39/102 378)〕 .In group A, the number of subjects who received colorectal cancer screening conducted by 15 general practitioners and disease prevention staff was 4 436, with each health worker conducting screening on 295.7 subjects; in group B, the number of subjects who received colorectal cancer screening conducted by 6 assistants for general practitioners was 4 000, with each assistant finishing screening on 666.6 subjects.In group A, the number of subjects older than 65 years old who received physical examination was 2 684, with each health worker conducting physical examination on 178.9 subjects older than 65; in group B, the number of subjects older than 65 years old who received physical examination was 6 263, with each assistant conducting physical examination on 1 043.8 subjects older than 65.Conclusion Assistants for general practitioners may facilitate the delivery of family doctor service , make the service mode more flexible and improve the work efficiency of GP team.They can also make it possible for more public -benefit screening programs financed by government to be carried out in communities.
