Study On The Standardized Workload Of Contract Service For Family Doctors In Guangzhou

1.Background and significanceFamily doctor contract service is an important measure to deepen the reform of primary health care and realize the whole life cycle and health process in China.The connotation and characteristics of the contracted service supply of family doctors are different from those of the original community United States Public Health Service,and they have their particularity in service mode,route and content.How to measure the workload of the contracted service of family doctors more accurately and reasonably,it is an important premise to measure the financial subsidy of family doctor’s contract service and to establish the performance appraisal system.The current service workload lacks standardization and the level of input funding is relatively fixed,it is unscientific and unreasonable to simply extrapolate this innovative new supply model of "family doctors" from the original workload measurement of community United States Public Health Service,the calculation and application of the standardized workload of the contract service of family doctors is of theoretical and practical value,which is helpful to enhance the efficiency of the resource allocation of the contract service.2.The study aimsCharacteristics and laws of the supply of new primary health care services contracted by family doctors,to establish a measurement system that can fully reflect the value of family doctor’s contract service and objectively reflect the workload of family doctor’s contract service,and to establish a scientific and reasonable measurement model by using RBRVS model,the workload of contract service of family doctors is standardized and calculated,the RVUS and function derivation formula are established,and the financial subsidy and performance evaluation are calculated by using standardized workload model,which is compared with the current subsidy standard,it provides an important reference for the establishment of scientific and reasonable financial subsidies and comprehensive and effective performance appraisal mechanism.3.MethodsAnalysis were used to understand the main methods and current situation of performance evaluation research and standardized workload of family doctor contract service.By using model construction method and RBRVS model system,the standardized workload questionnaire of contract service of family doctors was designed,and the time,physical strength,risk,technical difficulty and comprehensive workload of contract service of family doctors were investigated.Questionnaire survey method was used to investigate the workload of doctors in primary health care institutions in Guangzhou,taking the contracted medical staff of family doctors in 60 community health service centers as the subjects.An empirical study was conducted to investigate the rationality of RBRVS points table of family Doctor Contract Service,to conduct obj ective observation verification and subjective evaluation,and to organize stakeholder consultation.In the stage of statistical analysis,Spss23.0,Excel and SAS9.2 were used to carry out descriptive analysis,reliability and validity test,multiple linear regression,Ridge regression and so on.4.Results(1)The RBRVS table of work load of contract service for family doctors in Guangzhou was established:152 items of contract service for family doctors in Guangzhou were measured by RBRVS,it provides a reference for the measurement of the workload of family doctors.(2)The derivation of RBRVS point function is established:According to different service packages,13 separate relations are established.For not included in the measurement of the project,or the subsequent addition of the project to make a reference.(3)The application and discussion of RBRVS points table:This paper discusses the application of RBRVS points table in performance distribution scheme and financial compensation scheme.Put forward with incentive financial compensation and income distribution mechanism,and constantly improve the financial compensation and performance wage distribution program.(4)Policy suggestions:this paper puts forward some policy suggestions,such as establishing scientific and reasonable guarantee mechanism of financial investment and performance evaluation system,promoting the normalization and systematization of work count and the development of community informatization.