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目的对比家庭医生服务落实前后家庭病房服务情况的变化,以指导优化社区卫生服务。方法对深圳市宝安区西乡街道全部38家社区卫生服务中心在家庭医生服务模式全面实施前(2014年1-12月)、后(2015年1-12月)的家庭病床服务报表数据、质控考核结果进行回顾性对比分析。结果实施前后,年建床总数由22 541张上升为25 682张,诊疗总人次由45 933人次上升为53 175人次,专职医生由317人减少为135人,家庭医生由0人增加为621人。实施后家庭病床服务医生人均建床数、上门诊疗数明显低于实施前,差异有统计学意义(P<0.01)。实施后诊疗管理质量、病史质量、护理质量均明显高于实施前,差异有统计学意义(P<0.01)。结论家庭医生服务能够在减少专职医生的基础上增加家庭医生,使家庭病床服务人数增加,建床总数和家床诊疗总次数上升,而人均建床数、上门诊疗数下降,这有助于较少单个服务医生的工作量,并提高其工作质量。
Objective To compare the changes of family ward service before and after the implementation of family doctor service to guide the optimization of community health service. Methods All 38 community health service centers in Xixiang streets of Bao’an District of Shenzhen City before the full implementation of family doctor service mode (from January to December 2014) and after (from January to December 2015) family bed service reporting data Control examination results for retrospective comparative analysis. Results Before and after the implementation, the total number of beds built in each year increased from 22 541 to 25 682, the total number of visits increased from 45 933 to 53 175, the number of full-time doctors decreased from 317 to 135, and that of family doctors increased from 0 to 621 . After implementation, the number of hospital beds per bed built up by the family doctor and the number of on-site visits were significantly lower than those before the implementation, with a significant difference (P <0.01). After the implementation of the quality of medical management, medical history quality, quality of care were significantly higher than before the implementation, the difference was statistically significant (P <0.01). Conclusion Family doctor service can increase the number of family doctors based on the reduction of full-time doctors, increase the number of family beds, increase the total number of beds and the total number of family beds, and decrease the number of beds per person and the number of visits and clinics Reduce the workload of a single service doctor and improve the quality of their work.