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目的北京市开展家庭医生式服务5年,目前对家庭医生式服务的研究多集中于城区家庭医生式服务现状与对策研究、服务模式及激励机制研究等,而对农村家庭医生式服务极少涉及。本研究通过对郊区县全科医生进行访谈,了解北京市郊区县家庭医生式服务开展的现况,为今后郊区县家庭医生式服务的发展提供对策和建议。方法 2014年11月—2015年1月,对来自北京市10个郊区县16名全科医生进行专题小组访谈,并对访谈资料进行编码、归类、精简,总结出访谈主题。结果通过对北京郊区县全科医生的访谈,目前家庭医生式服务的开展情况有如下特点:1家庭医生式服务内容与患者需求尚有差距,导致患者对家庭医生式服务认可度低;2家庭医生式服务配套政策与措施急需完善;3基层待遇低,导致社区卫生人员不足,家庭医生式服务增加了日常工作量;4远郊区县家庭医生式服务主要签约方式为上门签约,服务方式为定期下乡巡诊;5远郊区县的家庭医生式服务团队中乡村医生承担了重要角色,防保人员的作用有待发挥;6家庭医生式服务未达到预期成效,但医患关系得到改善。结论北京市郊区县家庭医生式服务的发展,应充分发挥乡村医生的作用;继续加强对家庭医生式服务的宣传引导;同时应优化家庭医生式服务内涵,满足重点人群的卫生服务需求;不断完善与家庭医生式服务相配套的政策与措施,促进郊区县家庭医生式服务发展。
Objective To carry out family doctor service in Beijing for five years. At present, the research on family doctor service focuses on the study of the current situation and countermeasures of family doctor service in urban areas, and the research on service mode and incentive mechanism. However, it is seldom involved in the family doctor service in rural areas . In this study, interviews with GPs in suburban counties were conducted to understand the status quo of family physician services in suburban counties in Beijing, and to provide suggestions and measures for the future development of family physician services in suburban counties. Methods From November 2014 to January 2015, 16 general practitioners from 10 suburban counties of Beijing were interviewed and the interview materials were coded, categorized and streamlined to summarize the interview topics. Results Through the interviews with general practitioners in suburban counties of Beijing, the current development of family doctor services has the following characteristics: 1 There is still a gap between the contents of family doctor services and patient needs, resulting in low recognition of family doctor services; 2 Family The need for perfecting the policies and measures of doctor-based service support; (3) The low level of grass-roots treatment leads to the shortage of community health workers and the increase of routine workloads for family physicians; (4) The main contractual forms of family doctor- Rural doctor-patrolling; 5 rural doctor plays an important role in the family doctor-style service team in the outskirts counties and the role of prevention and protection personnel needs to be played; 6 family doctor service did not achieve the expected results, but the doctor-patient relationship was improved. Conclusion The development of family doctor service in suburban districts and counties of Beijing should give full play to the role of village doctors, continue to strengthen the propaganda and guidance of family doctor services, and at the same time optimize the connotation of family doctor services to meet the needs of key population health services. Policies and measures that match family doctor services to promote the development of family doctor services in suburban counties.