关键词: 家庭医生信心指数, 全科医生, 问卷调查, 上海

Abstract: Objective　To understand and explore the changes in the past three years （2014—2017） and the forthcoming three years in the confidence index of family doctors （CIFD） in Shanghai Pudong New Area，and to provide assistance for furtherance of the family doctor system.Methods　All family doctors in the 9 community health service centers surveyed in 2014 were surveyed again using an online questionnaire （www.wjx.cn） in December 2017.The questionnaire was independently designed based on the actual situation in Pudong New Area in Shanghai and the CIFD surveys of the China Medical Tribune General Practice weekly and Gu Yuan Family Doctors' Studio.The main survey included：general practitioner's （GP's） attention to family doctors' work，six major factors influencing family doctor practice，CIFD，changes in the practice status，the ability and demand to engage in family doctor services，the current medical reform policy，the Medical Consortium，the improvement in family doctors' brand influence and other social hot topics.Results　A total of 309 questionnaires were distributed，and 307 valid questionnaires were returned resulting in an effective recovery rate of 99.35%.Of 307 GPs，181 （58.96%） were constantly concerned about family doctors' work，124 （40.39%） were sometimes concerned，and 2 （0.65%） were not concerned.The weights of the six major influencing factors for family doctors' practice，ranked in descending order were：wages and benefits （80 cases，26.06%），personal value realization （76 cases，24.76%），practice environment（57 cases，18.57%），social respect （51 cases，16.61%），career promotion （25 cases，8.14%），and work-life balance （18 cases，5.86%）．The 307 GP's CIFD in 2017 ranged from 0 to 100 points，with an average of （45.1±21.7） points，which was higher than that in 2014 （24.6±22.8） points （t=-1.779，P<0.05）；but lower than the average expected index in 2017 （66.0 ± 20.8） points （t=-2.065，P<0.05），and the average expected value in 2020 （48.2±23.1） points （tpaired=-4.515，P<0.05）．There was a statistically significant difference between the expected CIFDs in 2017 and 2020 in different unit locations （where CIFDs of doctors in suburban units > those in urban and urban fringe areas） （P<0.05）．The differences were statistically significant for the 2017 and 2020 CIFDs of junior，intermediate，sub-senior and above persons；units in urban areas，urban fringe areas and suburban areas；community health work for 3-<10 years，10-20 years，and >20 years （P<0.05）．Conclusion　The 2017 GP's CIFD index in Shanghai Pudong New Area is greater than that in 2014，and this may be attributable to the current income level，practice environment，personal value realization，and career promotion.The expected CIFD value in 2020 is slightly higher.

Key words: Family doctor confidence index, General practitioner, Questionnaires, Shanghai