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家庭医生成分级诊疗不可或缺一环 未来需进一步完善

2017-05-12 10:51:21   经济参考报

  居民体验更方便、实惠

作为新生事物,社区居民如何了解家庭医生的服务模式?青海省西宁市城西区虎台卫生服务中心家庭签约医生莫红姑说,除了媒体的相关报道外,社区卫生服务中心还会利用分散各处的大屏幕进行滚动播放,并发放免费宣传资料。

“我们还会利用上门给居民建立健康档案的时机,向他们普及家庭医生签约服务的信息和政策。社区民众来门诊的时候,我们在做健康教育的同时,还会讲家庭医生签约服务的内容、好处等,逐渐居民们就了解相关知识。”莫红姑说。

71岁的段启文是云南省昆明市盘龙区万宏路社区居民,他2009年签订了全科医生团队服务协议。在段启文看来,“方便、实惠、顺畅”是家庭医生服务的最大特点。“我随时可以打电话向家庭医生咨询就诊、用药、医保等各方面信息。在家庭医生指导下,我的慢性病一直控制得很好。”段启文说。

在陕西省西安市东窑坊小区,家庭医生工作室每周二、周四到小区来为居民服务。作为高血压患者,居民王清莲就会找到签约家庭医生检查咨询。“家庭医生的电话24小时都能打通,不舒服随时都可以咨询”,王清莲说,“以前我老得跑大医院,现在小区就把病看了,我已经两年没去过大医院了。”

在基层,也有不少群众担心家庭医生“水平有限”,心存疑虑。对此,中国社科院人口与劳动经济研究所社会保障研究室主任陈秋霖表示,家庭医生代表的是一个体系、团队,只有为签约对象很好地解决问题,提供优质的服务,让居民实际受益,才能建立起信任关系。

  未来家庭医生服务更为多元

对家庭医生服务的未来,中国人民大学医改研究中心主任王虎峰说,未来家庭医生要根据需求提供服务,居民的需求会非常多样,需要分门别类解决。

“居民中有的是重点人群,老年人、儿童、孕妇;有康复期的,有刚发病的;有家庭病房,有临终关怀,需求是多层次、多样化的”,王虎峰说。

他说,将来十几亿的人口全面签约服务,不可能有这么多的医生做工作,这就需要分类、分级。“有一些工作是全科医生做的,有一些可能就是全科护士,还可能是健康管理师,还会有一些和志愿者、社会工作者共同工作。这需要整合资源,做系统支持。未来就要以社会治理的理念,在更大程度上整合资源,满足不同需求”,王虎峰说。

记者调查发现,目前在一些地区社区医院向上级医院转诊的机制还不顺畅,难以及时协调、帮助病人得到专业的治疗。

对此,王虎峰表示,转诊问题在一些地区不同程度的存在,这需要医疗机构真正理解、落实分级医疗。“三级医院就是要把疑难重症收上来,把普通病人放下去。只有这样三级医院未来才有合理发展的空间,与社会需求相适应,未来才能发展得越来越好。如果三级医院不和基层进行双向转诊,自成‘孤岛’,是不可持续的,因为分级诊疗这个趋势是不可动摇的。”王虎峰说。

(本文由记者姜辰蓉、字强、杨一苗、王大千采写)

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