發(fā)布時間：2018-01-11 18:24

  本文關(guān)鍵詞：互聯(lián)網(wǎng)背景下城市家庭醫(yī)生服務(wù)能力建設(shè)研究　出處：《中國科學(xué)技術(shù)大學(xué)》2017年博士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 家庭醫(yī)生 服務(wù)能力 互聯(lián)網(wǎng) 多源流分析 中介作用 調(diào)節(jié)作用

【摘要】：家庭醫(yī)生制度創(chuàng)新是中國醫(yī)改的一個重要基礎(chǔ),它著力于解決中國醫(yī)改的三大基礎(chǔ)性問題。即如何構(gòu)建以社區(qū)服務(wù)為基礎(chǔ)的新型城市醫(yī)療服務(wù)體系,實現(xiàn)"社區(qū)首診、雙向轉(zhuǎn)診、逐級診療"的政策目標(biāo),最終解決由供需失衡導(dǎo)致的"看病難"問題和過度就醫(yī)導(dǎo)致的"看病貴"問題。同時如何適應(yīng)我國當(dāng)前醫(yī)學(xué)模式的轉(zhuǎn)變和人口老齡化的現(xiàn)實狀況,突破目前防治分離的傳統(tǒng)服務(wù)模式,真正做到防治結(jié)合,從而整體提高醫(yī)療衛(wèi)生服務(wù)的質(zhì)量和效率。互聯(lián)網(wǎng)醫(yī)療呈現(xiàn)了強勁的發(fā)展勢頭,互聯(lián)網(wǎng)成為我國解決"看病難,看病貴"的關(guān)鍵要素之一,能為家庭醫(yī)生的診療能力提供強大的臨床決策輔助系統(tǒng)和技術(shù)性指導(dǎo)。新技術(shù)的發(fā)展,實現(xiàn)人的數(shù)字化能力與數(shù)字資源的無縫集成與利用,建立人與計算機系統(tǒng)之間更為緊密、更富成效的伙伴關(guān)系,提供了"人機協(xié)同"的可能性,可以讓家庭醫(yī)生得到前所未有的醫(yī)療衛(wèi)生信息系統(tǒng)的幫助。隨著移動互聯(lián)網(wǎng)的發(fā)展和普及,家庭醫(yī)生甚至能夠隨時隨地的獲得外部信息系統(tǒng)和其他高水平醫(yī)生的實時指導(dǎo)。在醫(yī)療衛(wèi)生領(lǐng)域,家庭醫(yī)生是最適宜也是最需要開展"人機協(xié)同"研究的對象。家庭醫(yī)生的性質(zhì)和在醫(yī)療服務(wù)體系中所處的位置,讓家庭醫(yī)生在處理問題方面不同于�？漆t(yī)生。家庭醫(yī)生往往"單獨作戰(zhàn)",在實際工作中,很難在物理空間中形成與同事的協(xié)同配合和技術(shù)支持。家庭醫(yī)生面對的問題也是點多面廣,相應(yīng)的,對知識結(jié)構(gòu)和能力要求,也是要具備足夠的寬度和廣度,在此基礎(chǔ)上增加深度提升精度。借助互聯(lián)網(wǎng)技術(shù),實現(xiàn)家庭醫(yī)生的"人機協(xié)同",對于提升家庭醫(yī)生的服務(wù)能力具有重要意義,但是國內(nèi)較少有研究關(guān)注互聯(lián)網(wǎng)背景下的家庭醫(yī)生服務(wù)能力建設(shè)研究。本研究通過梳理國內(nèi)外家庭醫(yī)生制度演變過程和歸納國內(nèi)部分地區(qū)家庭醫(yī)生試點情況,系統(tǒng)介紹了家庭醫(yī)生制度實踐發(fā)展的具體情況。通過從制度經(jīng)濟學(xué)、福利經(jīng)濟學(xué)、管理心理學(xué)等多學(xué)科角度對家庭醫(yī)生制度的構(gòu)建進行了理論分析。采用多源流理論的研究方法和視角對我國家庭醫(yī)生制度建設(shè)和政策出臺過程進行分析和總結(jié)。在定性研究基礎(chǔ)上,通過對合肥市包河區(qū)和蜀山區(qū)內(nèi)家庭醫(yī)生現(xiàn)狀進行問卷調(diào)查,歸納總結(jié)了家庭醫(yī)生的實踐運行情況。結(jié)合文獻分析,對影響家庭醫(yī)生服務(wù)能力建設(shè)的隱性變量進行構(gòu)建的測量,對相關(guān)關(guān)系和作用進行回歸分析,對結(jié)果進行討論,并提出研究結(jié)論。在對家庭醫(yī)生服務(wù)能力隱性影響因素的論證下,結(jié)合對我國家庭醫(yī)生的服務(wù)模式、服務(wù)內(nèi)容進行的分析和對我國互聯(lián)網(wǎng)醫(yī)療發(fā)展的模式進行歸納總結(jié)。在此基礎(chǔ)上,針對服務(wù)模式和服務(wù)內(nèi)容所指向的服務(wù)能力,在人機協(xié)同理念指導(dǎo)下,提出互聯(lián)網(wǎng)背景下我國家庭醫(yī)生服務(wù)能力提升的意見建議和實現(xiàn)路徑。
[Abstract]:The innovation of family doctor system is an important foundation of Chinese medical reform. It focuses on solving the three basic problems of Chinese medical reform, that is, how to build a new urban medical service system based on community service. Realize the policy goal of "community first consultation, two-way referral, step by step diagnosis and treatment". Finally solve the problem of "difficult to see a doctor" caused by imbalance between supply and demand and "expensive" caused by excessive medical treatment. At the same time, how to adapt to the change of current medical model and the reality of aging population in China. Break through the traditional mode of prevention and treatment separation, truly achieve the combination of prevention and treatment, so as to improve the overall quality and efficiency of health services. Internet medical care has shown a strong momentum of development. The Internet has become one of the key elements to solve the problem of "difficult and expensive to see a doctor" in our country. It can provide powerful clinical decision support system and technical guidance for the diagnosis and treatment ability of family doctors, and the development of new technology. To realize the seamless integration and utilization of human digital capability and digital resources, to establish a closer and more effective partnership between human beings and computer systems, and to provide the possibility of "man-machine cooperation". Family doctors can be helped by unprecedented medical and health information systems. With the development and popularity of the mobile Internet. Family doctors even have access to external information systems and real-time guidance from other high-level doctors anytime and anywhere. In the field of health care. Family doctor is the most suitable and the most need to carry out "man-machine coordination" research object, family doctor's nature and position in the medical service system. Let family doctors deal with problems differently from specialists. Family doctors often "work alone" in practice. It is difficult to form cooperation and technical support with colleagues in the physical space. Family doctors are faced with a wide range of problems, corresponding to the knowledge structure and ability requirements, but also to have enough width and breadth. On this basis, it is of great significance to improve the service ability of family doctors by increasing the depth of accuracy and realizing the "man-machine cooperation" of family doctors with the help of Internet technology. However, there are few researches on the capacity building of family doctor service under the background of Internet. This study summarizes the experimental situation of family doctor in some areas of China by combing the evolution process of family doctor system at home and abroad and summing up the pilot situation of family doctor in some regions of China. This paper systematically introduces the specific situation of the practice and development of the family doctor system through institutional economics and welfare economics. From the perspective of management psychology, this paper makes a theoretical analysis on the construction of family doctor system, and analyzes and summarizes the process of family doctor system construction and policy promulgation in China from the perspective of multi-source theory. On the basis of qualitative research. Based on the questionnaire survey of family doctors in Baohe District and Shushan District of Hefei City, this paper summarizes the practice of family doctors and analyzes the literature. To measure the hidden variables that affect the construction of family doctors' service capacity, to analyze the correlation and effect, and to discuss the results. And puts forward the research conclusion. Under the demonstration to the family doctor service ability recessive influence factor, unifies to our country family doctor service pattern. On the basis of the analysis of service content and the summary of the mode of development of Internet medical treatment in China, under the guidance of man-machine coordination concept, the service mode and service capability are pointed out. This paper puts forward some suggestions and ways to improve the service ability of family doctors in China under the background of Internet.
【學(xué)位授予單位】：中國科學(xué)技術(shù)大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R197.1

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本文編號：1410692