Research On Effect Evaluation And Improvement Strategy For Contract Service Mode With Family Doctors In Xi’an

Research purposes: Xi’an community health service was first built in 1998,and the community health service system covering all urban residents has been basically built.Nearly more than 600 general practitioner service teams have been established and more than 50 thousand households have been signed.However,the study of community health service in Xi’an,especially after the implementation of the family doctor contract service,has no knowledge about the degree of patient satisfaction,what problems exist,how to improve the contract rate,and improve the quality of service.This study,starting from two aspects of community residents and health service providers,systematically analyzes the status and influencing factors of the contract service service of family physicians in Xi’an,and provides a scientific basis for improving the signing rate and service effect of family physicians.Research methods: This study applies the literature review method,combined with the status of community health development in Xi’an,determines the direction of the study on the effect evaluation and promotion strategy of the contract service model of family physicians in Xi’an,and applies the Delphi expert consultation method to determine the contract service evaluation system of family physicians in Xi’an;according to the evaluation system,the system is divided into the evaluation system.Do not formulate the questionnaire of community residents and medical workers,use the questionnaire survey method to obtain the evaluation results of the residents and medical workers on the contract service,and get the corresponding conclusions to provide strong support for the promotion of the contract service.Results: We formed a service evaluation index system for family doctors in Xi’an,then divided into "Xi’an family doctor contracted service community residents questionnaire" and "Xi’an family doctor contracted service community medical workers questionnaire",which fully,scientifically,accurately and objectively evaluate the effect of contract service model for family doctors in Xi’an,and propose an improvement strategy.The contract rate of signing service for family physicians in Xi’an is 38.2%,which is higher than the average level in Xi’an.It basically meets the requirements of the Xi’an Municipal Health Planning Commission in the end of 2017.The community residents’ health care for immunized children,the establishment of health records,the health management of the elderly,and community health services for the residents of the city.The satisfaction of the fees,health education and other projects is high,and the satisfaction of the elderly family diagnosis and care,the general practitioner’s diagnosis and treatment level,the telephone health consultation,the signing service propaganda and the contract service publicity are low.The medical workers’ work stability,the way of leadership management,the execution and leadership of the contract service system are carried out.Management ability and contracted service management system are more satisfactory,which are low in salary income,welfare benefits,salary distribution system,rewards and punishment system and training opportunities.Conclusion: We formed a service evaluation index system for family doctors in Xi’an,the contract rate of signing service for family physicians in Xi’an is low,the community residents are more satisfied with the long-term service,and the level of diagnosis and treatment is lower.The community medical workers are satisfied with the nature of the work,the leading factors and the lower satisfaction on the factors of salary and the factors to be treated.