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目的了解巡诊服务模式在京北山区社区卫生服务中的开展情况及发挥的作用、存在的问题,并提出改进建议。方法由全科医生、社区护士、防保人员、药剂人员经培训后组成巡诊小组,携带血压计、心电图机、快速血糖仪及部分常用药品,到辖区行政村开展常见病诊疗以及高血压、糖尿病等慢性病管理、老年人健康管理、健康教育等服务;对2012~2014三年下乡巡诊服务情况进行统计,同时收集该机构同期门诊、急救服务相关数据,并对2组数据进行比较分析。结果三年来,巡诊次数和参加巡诊医务人员数逐年增加,巡诊服务对象中,60岁以上老年人比例明显高于同期门诊、急诊患者中老年人比例;三年中,老年人健康管理、慢性病患者健康管理人数持续上涨;居民对社区卫生服务的满意度逐年提高。结论巡诊服务能够降低社区卫生服务机构人力成本,能够促进社区卫生服务机构老年人健康管理、慢性病患者健康管理等基本公共卫生服务工作的开展;该模式比较适合留守老人较多的山区,同时相对于专家巡诊,该模式具有长期性、持续性的特点,并且与社区卫生机构承担的健康管理等工作相结合,能够根据巡诊对象的实际需求,随时调整服务内容,形式更灵活,内容更适应居民健康需求;但是也存在巡诊服务项目少、药物供应不全、社区卫生服务机构交通费用增加等问题,建议通过改善卫生室环境、统一药品目录等途径解决相应问题。
Objective To understand the status quo, functions and existing problems of patrolling service mode in community health service in north Beijing mountain area and to put forward suggestions for improvement. Methods The GPs, community nurses, anti-insurers and pharmacy staffs were trained to form a tour group that carried sphygmomanometers, ECG machines, rapid blood glucose meters and some commonly used medicines to go to the administrative villages in the area for diagnosis and treatment of common diseases as well as hypertension and diabetes Such as chronic disease management, elderly health management, health education and other services; the 2012 to 2014 three-year patrol service statistics, while collecting the agency outpatient services, emergency services related data, and two sets of data for comparative analysis. Results In the past three years, the number of visits and the number of medical workers participating in the clinic increased year by year. The proportion of elderly people over the age of 60 was significantly higher than that of outpatients and emergency patients during the same period. In the three years, the elderly, health management, The number of health management continued to rise; residents’ satisfaction with community health services increased year by year. Conclusion The tour service can reduce the labor costs of community health service agencies and promote the development of basic public health services such as health management for the elderly in community health service agencies and health management for chronic patients. This model is more suitable for staying in mountainous areas with more elderly people, This model has long-term and persistent characteristics and is integrated with the health management undertaken by community health agencies to adjust the service content at any time according to the actual needs of the target persons. The content is more flexible and the content is more suitable for residents’ health However, there are also some problems such as the small number of tour service items, incomplete drug supply and the increase of transportation costs of community health service agencies. It is suggested to solve the problems by improving the environment of the clinic and unifying the drug catalogs.