Volume 23 Issue 9
Sep.  2025
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XU Chao, ZHAO Yali, CHANG Yi. The development status and optimization suggestions of family doctor contract services in Beijing based on policy framework[J]. Chinese Journal of General Practice, 2025, 23(9): 1449-1453. doi: 10.16766/j.cnki.issn.1674-4152.004153
Citation: XU Chao, ZHAO Yali, CHANG Yi. The development status and optimization suggestions of family doctor contract services in Beijing based on policy framework[J]. Chinese Journal of General Practice, 2025, 23(9): 1449-1453. doi: 10.16766/j.cnki.issn.1674-4152.004153
shu

The development status and optimization suggestions of family doctor contract services in Beijing based on policy framework

doi: 10.16766/j.cnki.issn.1674-4152.004153
  • 1.

    Community Management Section, Chaoyang District Medical Institution Management Center, Beijing 100021, China

Funds:

 专20240042

  • Received Date: 2024-12-06
    Available Online: 2025-11-17
    Abstract
  • Against the backdrop of deepening medical reform, family doctor contract services have become a crucial means to promote hierarchical medical treatment. In 2016, China fully launched family doctor services, and subsequent policies have steadily enhanced service quality and expanded coverage. The development of family doctor services in Beijing has progressed through three stages: exploration, comprehensive promotion, and in-depth advancement, gradually improving the service model. At present, Beijing has established a financing mechanism supported by government, medical insurance, and individual contributions. Medical insurance offers preferential policies for contracted residents, while tertiary hospitals provide resource support to primary healthcare institutions. A four-level management model has been implemented, continuously enriching service content. By the end of 2024, there were 6 000 family doctor teams, with a contract rate exceeding 40%, supported by a performance-based assessment and incentive system. However, several policy limitations in Beijing' s family doctor contract services remain, including insufficient guidance and constraints under the health insurance policy for residents to engage in contracting, ambiguous hierarchical diagnosis and treatment pathways mentioned in the policy related to family doctor contract services, unclear delineation of the service contents of different levels of healthcare institutions at this stage, absence of a unified citywide information platform covering all major healthcare service institutions, lack of clear basis or inflexibility in charging fees for additional family doctor contract services, and shortcomings in the assessment and incentive mechanisms for doctors. To address these challenges, we recommend: (1) Strengthening the guiding and restraining role of medical insurance and related policies, making contracting a prerequisite for access to new preferential policies; (2) Establishing clear rules for hierarchical diagnosis and treatment to clarify the duties and obligations of all parties, and removing technical and information system barriers between institutions; and (3) Optimizing incentives and pricing mechanisms, strengthening policy coordination, so as to promote the high-quality development of family doctor contract services.

     

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    • References(27)
  • [1]
    赵春青. 家庭医生式服务居民健康的"守门人"(一)[J]. 健康, 2014(3): 1.

    ZHAO C Q. Family doctor-type service "gatekeeper" of residents' health (Ⅰ)[J]. Health, 2014(3): 1.
    [2]
    赵京. 家庭医生走进京城千家万户[J]. 首都医药, 2011, 18(21): 35-36.

    ZHAO J. Family doctors enter thousands of households in the capital[J]. Capital Medicine, 2011, 18(21): 35-36.
    [3]
    国务院医改办, 国家卫生计生委, 国家发展改革委, 等. 关于印发推进家庭医生签约服务指导意见的通知: 国医改办发〔2016〕1号[A/OL]. (2016-06-06)[2025-06-09]. https://www.gov.cn/xinwen/2016-06/06/content_5079984.htm.
    [4]
    国务院办公厅. 国务院办公厅关于改革完善全科医生培养与使用激励机制的意见: 国办发〔2018〕3号[A/OL]. (2018-01-14)[2025-06-09]. https://www.gov.cn/gongbao/content/2018/content_5264866.htm.
    [5]
    人力资源社会保障部, 财政部, 国家卫生健康委. 《关于完善基层医疗卫生机构绩效工资政策保障家庭医生签约服务工作的通知》(人社部发〔2018〕17号)[Z]. [2025-08-18]. https://pyrs.puyang.gov.cn/?mv=pc_fwzx&a=newsview_4191.
    [6]
    国家卫生健康委员会, 国家中医药管理局. 关于规范家庭医生签约服务管理的指导意见: 国卫基层发〔2018〕35号[A/OL]. (2018-09-29)[2025-06-09]. https://www.gov.cn/zhengce/zhengceku/2018-12/31/content_5435461.htm.
    [7]
    国家卫生健康委员会. 关于推进家庭医生签约服务高质量发展的指导意见: 国卫基层发〔2022〕10号[A/OL]. (2022-03-03)[2025-06-09]. https://www.gov.cn/zhengce/zhengceku/2022-03/15/content_5679177.htm.
    [8]
    王波, 岳林琳, 国昭贤. 家庭医生签约服务背景下社区居民就医行为影响因素分析[J]. 卫生经济研究, 2023, 40(4): 52-55.

    WANG B, YUE L L, GUO Z X. Analysis of factors influencing community residents' medical behavior in the context of family doctor contracting service[J]. Health Economics Research, 2023, 40(4): 52-55.
    [9]
    江萍. 上海市长宁区家庭医生签约服务实践[J]. 中国卫生人才, 2019(7): 18-21.

    JIANG P. Practice of family doctor contracting service in Changning District, Shanghai[J]. China Health Human Resources, 2019(7): 18-21.
    [10]
    季晖. 基于倾向性评分的"1+1+1"医疗机构组合签约效果研究[J]. 中华全科医学, 2023, 21(3): 449-453. doi: 10.16766/j.cnki.issn.1674-4152.002905

    JI H. Study on the effect of "1+1+1" medical organization combination contracting based on propensity score[J]. Chinese Journal of General Practice, 2023, 21(3): 449-453. doi: 10.16766/j.cnki.issn.1674-4152.002905
    [11]
    孙雍容. 浙江杭州: 护航医养护一体化签约服务[J]. 中国卫生, 2021(6): 20-21.

    SUN Y R. Hangzhou, Zhejiang Province: Escorting the integration of medical care contracting service[J]. China Health, 2021(6): 20-21.
    [12]
    唐国宝, 姜杰. 厦门市"三师共管"家庭医生签约模式的实践与效果探讨[J]. 中华全科医师杂志, 2018, 17(7): 510-513.

    TANG G B, JIANG J. Discussion on the practice and effect of the "three-division co-management" family doctor contracting model in Xiamen[J]. Chinese Journal of General Practitioners, 2018, 17(7): 510-513.
    [13]
    蒋祥, 王芳, 田淼淼, 等. 县域医共体背景下安徽省定远县家庭医生签约服务进展分析[J]. 中国卫生政策研究, 2019, 12(4): 50-55.

    JIANG X, WANG F, TIAN M M, et al. Analysis of the progress of family doctor contracting service in Dingyuan County, Anhui Province under the background of county medical community[J]. Chinese Journal of Health Policy, 2019, 12(4): 50-55.
    [14]
    BRAZAI M S, MAJEED A. General Practice in England: the current crisis, opportunities, and challenges[J]. J Ambul Care Manage, 2022, 45(2): 135-139. doi: 10.1097/JAC.0000000000000410
    [15]
    Australian Government Department of Health and Age. General practice workforce providing primary care services in Australia[EB/OL]. (2024-12-18)[2025-06-09]. https://hwd.health.gov.au/resources/data/gp-primarycare.html.
    [16]
    OECD. Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris. [2025-07-22]. https://doi.org/10.1787/7a7afb35-en.
    [17]
    Health Careers. Working life (GP)[EB/OL]. (2024-10-04)[2025-06-09]. https://www.healthcareers.nhs.uk/explore roles/doctors/roles-doctors/general-practice-gp/working-life.
    [18]
    SCHǍFER W, VAN DEN BERG M, BOERMA W, et al. Taakprofielen van huisartsen in Nederland en Europa[J]. Huisarts en wetenschap, 2016, 59(7): 286-291. doi: 10.1007/s12445-016-0177-y
    [19]
    Medscape. Physician compensation report 2022[EB/OL]. (2022-04-15)[2025-07-22]. https://physiciansthrive.com/wp-content/uploads/2022/02/Physician-Compensation-Report-2022.pdf.
    [20]
    贾梦, 管雪帆, 孟禹呈, 等. 我国家庭医生签约服务费筹资与支付现状调查研究[J]. 中国卫生经济, 2023, 42(9): 66-69.

    JIA M, GUAN X F, MENG Y C, et al. A study on the current situation of financing and payment of contracted service fees for family doctors in China[J]. Chinese Health Economics, 2023, 42(9): 66-69.
    [21]
    张向东, 刘亚军. 家庭医生签约服务的"北京探索"[J]. 中国卫生人才, 2022(5): 42-45.

    ZHANG X D, LIU Y J. The "Beijing exploration" of family doctor contracting service[J]. China Health Human Resources, 2022(5): 42-45.
    [22]
    柳馨, 付晓彤, 彭宗超. 家庭医生服务政策的执行变迁及优化路径: 基于"模糊-冲突"的理论视角[J]. 江淮论坛, 2022(6): 123-127.

    LIU X, FU X T, PENG Z C. Implementation Changes and Optimization Paths of Family Physician Service Policies: Based on the Theoretical Perspective of "Ambiguity-Conflict"[J]. Jiang-huai Tribune, 2022(6): 123-127.
    [23]
    北京市卫生健康委员会. 关于印发北京市改进家庭医生签约服务若干措施的通知[A/OL]. (2022-03-03)[2025-06-09]. https://wjw.beijing.gov.cn/zwgk_20040/ylws/202311/t20231106_3295252.html.
    [24]
    刘利群. 推进家庭医生签约服务加强分级诊疗制度建设[J]. 中国全科医学, 2018, 21(1): 1-4.

    LIU L Q. Promoting family doctor contracting service to strengthen the construction of hierarchical diagnosis and treatment system[J]. Chinese General Practice, 2018, 21(1): 1-4.
    [25]
    北京市人力资源和社会保障局. 北京市人力资源和社会保障局等部门关于签约家庭医生的超转人员取消首诊转诊的通知: 京人社超转发〔2024〕4号[A/OL]. (2024-03-18)[2025-06-09]. https://www.beijing.gov.cn/zhengce/gfxwj/202406/t20240624_3725316.html.
    [26]
    肖蕾, 张太慧, 张雅莉, 等. 分级诊疗视角下家庭医生签约服务"签而不约"的原因及对策研究[J]. 中国全科医学, 2018, 21(25): 3063-3068.

    XIAO L, ZHANG T H, ZHANG Y L. Research on the reasons and countermeasures of "signing but not contracting" of family doctor contracting service under the perspective of hierarchical diagnosis and treatment[J]. Chinese General Practice, 2018, 21(25): 3063-3068.
    [27]
    董婉君. 家庭医生签约服务政策执行偏差研究[D]. 广州: 暨南大学, 2022.

    DONG W J. Research on the implementation bias of family doctor contracting service policy[D]. Guangzhou: Jinan University, 2022.
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