城市家庭医生签约服务的区域失衡与破解路径

Regional Imbalance and Solution Paths of Urban Family Doctor Contract Services

摘要: 为推进家庭医生签约服务高质量发展，本研究以华东某城市主城区A、B、C、D 4个区域的225名签约居民为调研对象，通过问卷调查与深度访谈，结合TOPSIS法对服务感受度进行多维度综合评价。结果显示，4个区域服务感受度贴近度均值为0.646，区域排序为C区(0.904) > D区(0.729) > B区(0.610) > A区(0.341)；整体知晓率81.33% (服务包类型知晓率仅73.33%)，满意率82.44% (转诊便利性满意率69.78%)，续约率80.44%，服务需求匹配率77.11%。研究发现，华东某城市主城区家庭医生服务存在知晓率区域不均、转诊衔接不畅、个性化供给不足、区域资源配置失衡等突出问题。基于国家政策导向与地方实践需求，提出强化精准宣传、优化转诊机制、丰富个性服务、均衡资源配置四项优化建议，为提升居民服务感受度、推动家庭医生签约服务从“广覆盖”向“高质量”转型提供科学依据。

Abstract: To promote the high-quality development of family doctor contract services, this study selected 225 contracted residents from four districts (A, B, C, D) in the main urban area of a city in East China as research subjects. Through questionnaire surveys and in-depth interviews, combined with the TOPSIS method, a multi-dimensional comprehensive evaluation of service experience was conducted. The results show that the mean proximity of service experience in the four districts is 0.646, with the regional ranking as District C (0.904) > District D (0.729) > District B (0.610) > District A (0.341). The overall awareness rate is 81.33% (the awareness rate of service package types is only 73.33%), the satisfaction rate is 82.44% (the satisfaction rate of referral convenience is 69.78%), the renewal rate is 80.44%, and the service demand matching rate is 77.11%. The study finds that family doctor services in the main urban area of this East China city have prominent problems such as uneven regional awareness rates, unsmooth referral connections, insufficient personalized supply, and unbalanced regional resource allocation. Based on national policy orientation and local practical needs, four optimization suggestions are put forward: strengthening precise publicity, optimizing the referral mechanism, enriching personalized services, and balancing resource allocation. These suggestions provide a scientific basis for improving residents’ service experience and promoting the transformation of family doctor contract services from “wide coverage” to “high-quality” development.