A Study On The Implementation Bias Of Family Doctor Contract Service Policies

With the gradual aging of the population in China,the pressure of social life is increasing,and patients with chronic diseases in a healthy living state have shown an upward trend in recent years.At the same time,with the change of people’s ideological concepts,the masses’ requirements for the quantity and quality of medical and health services continue to rise.In order to alleviate the problem of difficulty in seeing a doctor and looking down on the disease,China has been exploring the model of community medical and health services since the 1990 s.As an important starting point for boosting the construction of China’s "Healthy China" strategy and promoting the realization of the goal of providing residents with all-round full-cycle health services,the family doctor contract service policy is also an important part of China’s promotion of the implementation of a hierarchical diagnosis and treatment system for medical services.Since its full launch in 2016,the signing rate nationwide has repeatedly reached a new high,and the number of signings has increased rapidly.However,at the level of implementing contracted services,there are still many problems,whether it is the community hospital execution carrier or the family doctor as the policy implementer,or the community resident as the policy beneficiary.In order to explore and solve the deviations in the implementation of the family doctor contract service policy,this paper selects the community health service center in community X as a case study,with the help of public policy implementation deviation,policy network and street bureaucracy theory,and follows the idea of "observing the deviation-summarizing the cause-finding countermeasures",through data survey,field research,interviews and other ways to comprehensively examine the specific behavior choices between the X community health service center,family doctor and community residents.It was found that there were problems such as ignoring individual needs,lack of flexibility in the form of services,selective performance,and resident contracts in the form of formalities.Through in-depth analysis of interview records and reading a large number of literature,from the three aspects of organizational structure,executive personnel and service recipients,the reasons for the deviation of the X community are comprehensively analyzed and targeted suggestions and countermeasures are proposed.It provides a certain reference significance for promoting the implementation of the family doctor contract service system and promoting the realization of the graded diagnosis and treatment system.