中国全科医学2017，Vol.20Issue(13)：1558-1563,6.DOI:10.3969/j.issn.1007-9572.2017.13.007
方庄社区家庭医生式服务推进分级诊疗的实践效果研究
Practical Effect of Family Doctor Service on Promoting Hierarchical Diagnosis and Treatment in Fangzhuang Community
摘要
Abstract
Objective To explore the practical effect of family doctor service on promoting hierarchical diagnosis and treatment in Fangzhuang community.Methods By equidistant random sampling method,587 patients with type 2 diabetes mellitus who signed contract with family doctors in Fangzhuang Community Health Service Center from 2011 to 2015 were selected as the study subjects.Their data taking type 2 diabetes mellitus and its complications as first diagnosis were extracted from the Beijing Management Center of Medical Insurance Affairs.A statistical analysis of these data including times of outpatient visiting and hospitalization,outpatient costs of medical care and medical insurance fund,hospitalization costs of medical care and medical insurance fund in primary health care institutions,secondary hospitals and tertiary hospitals was conducted in this study.Results From 2011 to 2015,there was significant difference in the per capita number of outpatient visit between primary health care institutions and tertiary hospitals among patients who had signed contract (P<0.05);there were no significant differences in the per capita number of outpatient visit and per capita number of hospitalization in secondary hospitals,and the per capita number of hospitalization in tertiary hospitals among the research subjects (P>0.05).From 2011 to 2015,there was significant difference in outpatient costs of medical care per capita between primary health care institutions and tertiary hospitals among the subjects (P<0.05);there were no significant differences in the per capita costs of medical care and hospitalization in secondary hospitals,and the per capita costs of hospitalization in tertiary hospitals among the research subjects (P>0.05).From 2011 to 2015,there was significant difference in the per capita costs of outpatient medical insurance fund between primary health care institutions and tertiary hospitals among the subjects (P<0.05);there were no significant differences in the per capita costs of outpatient and hospitalization medical insurance fund in secondary hospitals,and the per capita costs of hospitalization medical insurance fund in tertiary hospitals among the subjects (P>0.05).Conclusion The family doctor service in Fangzhuang community has effectively reduced the number of outpatient visit and saved medical expenses to a certain extent of patients with type 2 diabetes mellitus,and has a positive significance in achieving initial diagnosis in community and promoting hierarchical diagnosis and treatment system.关键词
家庭医生式服务/社区卫生中心/分级诊疗/糖尿病,2型/北京Key words
Family doctor service/Community health centers/Hierarchical diagnosis and treatment/Diabetes mellitus,type 2/Beijing分类
医药卫生引用本文复制引用
魏学娟,吴浩,于海洋,葛彩英,贾鸿雁,王丽,高文娟,黄雯,梁万年..方庄社区家庭医生式服务推进分级诊疗的实践效果研究[J].中国全科医学,2017,20(13):1558-1563,6.基金项目
首都卫生发展科研专项项目(2014-2-7051) （2014-2-7051）
北京市科委2013年资助课题(D131100004713002) （D131100004713002）
