北京市社区卫生服务机构实施收支两条线管理对机构服务质量的影响分析

Effect of Implementation of Separated Management of Income and Expenditure on the Service Quality in Beijing Community Health Service Institutions

目的了解收支两条线管理实施以后,社区卫生服务机构的服务质量总体水平有无变化。方法采用自行设计的《北京市社区卫生服务机构调查表》,调查北京市489家社区卫生服务机构和部分门诊患者,有效调查458家社区卫生服务机构,按照调查的社区机构是否已实施收支两条线管理,分为实施组(202家)和对照组(256家),并对收集的数据用SPSS 13.0软件进行统计学分析。结果2007年社区卫生服务机构对4种慢性疾病(高血压、糖尿病、冠心病、脑卒中)的管理质量维持了原有水平,健康教育情况、居民满意度和就医意向较以往有了明显改善,且实施组在进展上领先于对照组。结论实行收支两条线管理后,社区卫生服务机构的服务质量较以前有所提高,但是仍不理想,特别是公共卫生服务项目,有待于进一步加强以实现社区卫生服务公益性的早日回归。

Objective To find out whether the service quality of community health service(CHS) institutions had been improved following the implementation of separated management of income and expenditure.Methods The questionnaire survey was conducted in 489 CHS institutions and a part of the outpatients in Beijing,and the data was statistically analyzed by using SPSS 13.0 software.Results In 2007,the original levels of community management quality of chronic diseases(including hypertension,diabetes mellitus,coronary diseases and brain stroke) had been kept.The health education,residents′ evaluation and visiting intention had been obviously improved,and better in the intervention group than in the control group.Conclusion The service quality in CHS institutions has been improved following implementation of separated management of income and expenditure.Nevertheless,it is still not ideal,especially in public health services,which need to be further strengthened so as to get an early return of commonweal in CHS as soon as possible.