目的,探究不同特征的社区居民对签约意愿的影响及对家庭医生签约服务的期望.方法,采用自填式问卷调查,Epidata3.0建立数据库,SPSS.24对数据进行分析,以P＜0.05为差异具有统计学意义.结果,调查人数为370人,应答率为94.3％,居民愿意签约率为62.5％,学历、职业、居住地类型、医保类型影响社区居民对家庭医生签约的意愿;居民期望家庭医生的承担者为:公立医院医师(55.9％);签约费用为:100元以上(27.5％);服务内容为:合理用药指导(65％);常见病和多发病诊治(64.2％)以及签约服务形式为:上门服务(81.4％)等.结论,加强宣传,提高签约率;吸引家庭医生就业,加强家庭医生队伍建设;加强监督,实施绩效考核.

为进一步提升基层医疗机构服务水平,顺利推进分级诊疗制度,本研究运用SERVQUAL量表工具建立评价体系,从可靠性、有形性、保证性、移情性及响应性这五个维度入手,根据Servqual得分情况,得出实际感受值与期望值差距较大的两个维度,针对这两个维度,客观分析基层医疗机构的服务现状及原因,给出提高基层医疗机构服务质量的策略以供借鉴.

Objective To observe the influence of qisang fang on blood glucose ,serum lipoprotein and protein tyrosine phosphatase 1B(PTP1B)expression in type 2 diabetes rats .Methods Type 2 dia‐betes model was induced with high sucrose-fat diet and streptozocin ,rats were randomly divided into groups :normal group ,model group ,metformin treatment group ,qisang fang low dose treatment group ,qisang fang middle dose treatment group ,qisang fang high dose treatment group .Blood glucose , serum lipoprotein ,hemoglobin Alc (HbAlc) and PTP1B expression in rats were detected after treat‐ment .Results Compared with normal group ,HbAlc levels were significantly higher( P <0 0.1) ,LDL , TG and TCH were significantly increased( P <0 0.5) ,HDL decreased( P <0 0.5) in model group .Qi‐sang fang can reduce the levels of TG ,TCH ,LDL ,FBG ,HbAlc ,improve the level of HDL ,and inhibit the PTP1B expression in liver .Conclusion Qisang fang can effectively improve sugar and lipid metab‐olism in T2DM rats ,inhibit the PT P1B expression may be the mechanism .