健康发展与政策研究2024，Vol.27Issue(3)：218-223,6.DOI:10.12458/HDPR.202407016
政策干预对上海市家庭医生签约服务的影响:基于间断时间序列模型
The impact of policy intervention on family doctor contracting services in Shanghai:a disrupted time series model analysis
胡敏 1杨超 2吕芊芊 3张静雅 2万和平 4汤真清5
作者信息
- 1. 上海市静安区临汾路街道社区卫生服务中心,上海 200435
- 2. 上海市卫生健康委员会,上海 200125
- 3. 安徽省卫生健康委员会,安徽 合肥 230031
- 4. 上海市健康促进中心,上海 200040
- 5. 上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海 200031
- 折叠
摘要
Abstract
Objective To analyze the impact of the family doctor contract service policy in Shanghai on relevant contract indicators,providing decision-making references for the development of family doctor contract services.Methods Through the Shanghai Informationization Data Platform(Shanghai Community Health Comprehensive Management Platform),dynamic monitoring data of contract service management from August 2022 to April 2024 in 16 districts of Shanghai were collected.The data includes the number of contractees,contract coverage rate,community contract saturation,compliance of contracted communities,community visit rates,visit rates within contract groups,and coverage rates for key populations.With June 2023 as the policy intervention point,the interrupted time series model was utilized to analyze changes in contract indicators before and after the implementation of the family doctor contract target management policy.Results After the policy implementation,the number of contractees(10.884 9 million VS.9.296 2 million),contract coverage rate(43.7%VS.37.4%),and key population contract coverage rate(84.2%VS.79.1%)all increased,when compared to those before the contract with statistically significant differences(all P＜0.001).Regression analysis showed that after the policy implementation,the number of contractees,contract coverage rate,and contract coverage rate of key populations all presented an upward trend(all P＜0.05).However,there was no significant change in the long-term trend of contract saturation(P=0.441).The contract community visit rate indicated a downward trend(P＜0.01),while compliance of contract community revealed an increasing trend(P＜0.05),and there was no remarkable change in visit rates within the contract groups(P＞0.05).Conclusions The policy intervention has a significant short-term effect on contract coverage and contract flow,but there is a decreasing trend over time.It is recommended that future policies address the slowing growth trends and optimize the quality and efficiency of contract services.关键词
家庭医生签约服务/政策效果评估/时间序列分析/社区卫生服务/上海市Key words
family doctor contract service/policy effect evaluation/time series analysis/community health services/Shanghai分类
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胡敏,杨超,吕芊芊,张静雅,万和平,汤真清..政策干预对上海市家庭医生签约服务的影响:基于间断时间序列模型[J].健康发展与政策研究,2024,27(3):218-223,6.
