山西省社区医疗卫生服务评价研究

Research on Community Health Care and Medical Service Evaluation in Shanxi Province

目的:从追求公平可及性,提高服务效率,关注服务质量的宏观视角对山西省社区医疗卫生服务进行客观诊断评价,为科学合理制定基层公共卫生政策提供参考。方法:借用三维综合模型和WHO模块框架,采用卫生资源集聚度、秩和比排序、构建评价组合对社区医疗卫生服务多项指标进行综合分析。结果:2015-2020年社区医疗卫生资源机构数集聚度>0,配置充足;护士数处于相对不足的边界;医师数、床位数、卫生总费用集聚度均<0,呈现持续短缺情况。三维综合模型分档结果显示,2010-2015年卫生投入、服务效率、健康需要处于偏差水平,2016-2020年处于中等偏好水平。WHO模块框架结果显示,2010-2016年处于服务效率偏低资源投入不足的失衡状态;2017-2020年分配适宜相对均衡。结论:山西省社区医疗卫生服务需要优化与改进,政府应有的放矢优化社区医疗卫生资源配置,改善服务水平,提高服务效率,提升居民对社区医疗卫生服务的利用度和满意度。

Objective: From the macro perspective of pursuing fairness and accessibility, improving service efficiency and paying attention to service quality, this paper made an objective diagnosis and evaluation of community health care and medical service in Shanxi province, so as to provide references for the scientific and reasonable formulation of grassroots public health policies. Methods: Using the three-dimensional comprehensive model and the WHO module framework, the comprehensive analysis of multiple indicators of community health care and medical service was carried out by using the agglomeration of health resources, rank and ratio ranking, and the construction of evaluation combinations. Results: From 2015 to 2020, the number of community health care and medical resource institutions was more than 0, and the allocation was sufficient. The number of nurses was at the boundary of relative shortage. The number of doctors, the number of beds and the agglomeration degree of total health costs were all less than 0, showing a continuous shortage. According to the grading results of the three-dimensional comprehensive model, the health input, service efficiency and health needs were at the deviation level from 2010 to 2015, and at the medium preference level from 2016 to 2020. According to the results of WHO module framework, from 2010 to 2016, the service efficiency was low and the resource investment was insufficient. The distribution from 2017 to 2020 was appropriate and relatively balanced. Conclusion: Community health care and medical service in Shanxi province need to be optimized and improved, the government should optimize and improve the level of community health care and medical service, improve the efficiency of medical services, and enhance residents’ utilization and satisfaction with community health care and medical service.