2015•Zhongguo quanke yixueRequires access
Management Mode of Urban Community Public Health Services Within the Family Doctor System
WU Ya
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Abstract
Objective To explore a fit management mode of urban community public health services within the family doctor system and to provide references for further improvement. Methods We took Minhang District of Shanghai as the subject and investigate its management model of public health services within the family doctor system. Minhang District became a pilot place for family doctor- based community healthcare system in 2011. Since then,the management model of public health services in the district has merged with family doctor system gradually by taking a series of measures: the adjustment of organization andcoordination mechanism in community public health services,the organic integration of basic public health services closely related with clinic practice,the establishment of an informationized Internet service platform of family doctor system,the comprehensive budget management of public health service programs and the performance evaluation management of health workers. Results By the end of 2014,the number of residents contracted with family doctor system in Minhang District reached 1. 4367 million and all of them established family health records. The rates of maternal management and children management stayed at high level( ≥96%); the coverage rate of hypertension management 〔40. 73%( 211 518 /519 331) vs. 28. 70%( 149 075 /519 425) 〕,the rate of effective control on hypertension〔82. 13%( 173 720 /211 518) vs. 77. 51%( 115 548 /149 075) 〕,the coverage rate of diabetes〔37. 85%( 64 367 /170 058) vs. 21. 93%( 37 301 /170 091) 〕, the rate of effective control on the blood sugar of diabetic patients〔82. 43%( 53 058 /64 367) vs. 62. 77%( 23 413 /37 301) 〕and the coverage of students' health management〔99. 79%( 134 448 /134 733) vs. 91. 54%( 110 505 /120 718) 〕all increased( P 0. 001) compared with 2010. Conclusion Family doctor system may be a trend of the development of community public health services,which can better maintain the residents' health and enhance the public health service capacity. However, currently this system is associated with numerous limitations including the shortage of family doctors,weak public health service skills and concept,unclear division of difference services and imperfect department coordination,which are urgent to be solved.