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中文摘要: 目的 以投出、过程和产出三个维度国家评价指标体系，系统评价2018年天津市各区家庭医生签约服务的质量。方法 采用AHP层次分析群决策构建评价指标体系，采用灰色相关分析法对各区家庭医生签约服务的各指标关联系数和灰色关联度进行综合评价， 以期获得各区服务质量的情况及存在的问题。结果 通过灰色关联系数分析，可知环城4个区家庭医生签约服务质量总体上优于其他区、县，而涉农地区服务质量较差，主要是由于相关人力资源投入不足；市内6个区的相关系数得分在签约居民家庭医生处门诊人次数指标上表现较差，在该区域内集聚的大量优质的卫生资源，使得居民选择基层就诊意愿不高；滨海新区主要体现在家庭医生与患者之间存在签而不约的情况；如H1、H3的环城地区在基层卫生机构数量和基层卫生技术人员的配置上尚有不足，同时优质的专科资源集聚，导致签约居民家庭医生处门诊人次数较低。结论 各级政府部门及卫生行政机构应进一步调整卫生资源布局，明确机构功能定位，保持服务公平可及；同时多点施策，提升基层医疗卫生机构服务能力，提高医疗技术水平，吸引患者更多的选择基层就医。
中文关键词: 关键词 家庭医生团队 服务质量与效果 AHP层次分析 灰色关联分析
Abstract:Objective To systematically evaluate the quality of family doctor contract service in Tianjin districts in 2018 with the national evaluation index system of input, process and output. Methods AHP group decision making was used to construct the evaluation index system, and grey correlation analysis was used to comprehensively evaluate the correlation coefficient and grey correlation degree of each index of contracted service of family doctors in each district, so as to obtain the situation and existing problems of service quality in each district. Results according to the grey correlation coefficient analysis, the contracted service quality of family doctors in the four districts around the city was better than that of other districts and counties on the whole, while the service quality in the agriculture-related areas was poor, mainly due to the insufficient investment of related human resources. The score of correlation coefficient in the six districts of the city is poor in the index of the number of outpatients of the contracted resident family doctors. The large amount of high-quality health resources gathered in this region make the residents have low willingness to seek medical treatment at the grass-roots level. Binhai new area is mainly reflected in the fact that there is a sign between the family doctor and the patient. For example, the number of primary health institutions and the allocation of primary health technicians are still insufficient in H1 and H3 surrounding areas. Meanwhile, the concentration of high-quality specialized resources leads to the low number of outpatients signed by resident family doctors. Conclusion It is suggested that government departments and health
administrative agencies at all levels should further adjust the distribution of health resources, clarify the function positioning of the agencies, and maintain fair and accessible services. At the same time, multiple measures should be taken to improve the service capacity of grassroots medical and health institutions, improve the level of medical technology, and attract more patients to choose grassroots medical treatment.
keywords: Family physician team Service quality and effect Analytic Hierarchy Process, AHP Grey Relation Analysis, GRA
文章编号：3202006003 中图分类号：R 197 文献标志码：
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