目的 对北京市8个社区的居民开展问卷调查,对家庭医生式服务的干预效果进行评价.方法 根据机构规模、居民情况及经济、文化水平等因素在北京市海淀区、西城区、大兴区抽取8家社区卫生服务中心,其中试验组4家,对照组4家;在社区卫生服务中心辖区随机抽取社区居民为研究对象.对照组采用家庭医生式服务原模式,即2010年北京市开展家庭医生式服务以来形成的服务模式.试验组采用家庭医生式服务新模式,即在原模式基础上根据基线调查结果,改进服务内容和服务方式.两组家庭医生式服务模式均干预1年.采用自行设计的《家庭医生式服务调查问卷》,于家庭医生式服务干预前(2013年2-3月)对社区居民进行调查,家庭医生式服务干预1年后(2014年3-4月)再次进行调查.调查问卷的内容包括:社区居民的基本情况,对家庭医生式服务的知晓情况,对家庭医生式服务的满意度情况及对社区卫生服务的利用情况.采用倍差法评估家庭医生式服务的干预效果,用试验组与对照组干预前后的差值(DID)表现政策效应,DID大于0则说明政策效应为正向,反之为负向.结果 试验组居民对家庭医生式服务模式、家庭医生及其联系方式的知晓率提高,更多的居民通过电视、报刊、网络途径了解家庭医生式服务(DID>0,P<0.05).试验组家庭医生式服务的实施在降低支出方面起到了正向的作用(DID>0,P<0.05).结论 家庭医生式服务新模式能够有效增加对家庭医生式服务的宣传力度,降低医疗卫生费用.%Objective To conduct a questionnaire survey to residents of eight communities in Beijing,and evaluate the interventional effect of family doctor services.Methods According to the factors such as the size of organization,the residents′ situation and the economic and cultural level,eight community health service centers were selected from Haidian District,Xicheng District and Daxing District,and 4 in experiment group and 4 in control group.Community residents in the administrative region of community health service center were randomly selected as the research objects.The control group used the original mode of family doctor service,that is,the service model formed since the carrying out of family doctor service in Beijing in 2010 to carry out.The experiment group used a new model of family doctor service,that is to improve service content and service methods based on the original model according to the baseline survey results.Two groups were intervened with family doctoral service models for one year.The self-designed Family Doctor Service Questionnaire,before the intervention (February-March,2013) the community residents were investigated,and reinvestigated 1 year after interventions (March-April,2014).The questionnaire included the basic situation of the community residents,the awareness of family doctor service,the satisfaction of family doctor service and the utilization of community health service.The multiplier method was used to assess the intervention effect of family doctor service,the difference value before and after intervention (DID) between experiment group and control group presented a policy effect,and if DID > 0 indicated a positive policy effect,otherwise a negative policy effect.Results The awareness rate of the family doctor service model,family doctors and their contact information of the residents in experiment group had improved,more residents learn about family doctoral services through television,newspapers,and network (DID>0,P<0.05).The implementation of family doctorial services in experiment group played a positive role in reducing expenditure (DID>0,P<0.05).Conclusion The new model of family doctor service can effectively increase the publicity of family doctor service,and reduce medical and health costs.
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