全国社区卫生服务现状调查——东、中、西部地区社区卫生服务中心“六位一体”服务开展情况

A Survey on the Present Situation of Chinese Community Health Service-The Present Situation of "Six in One" in Community Health Service Centers of the Eastern,Middle and Western Areas

目的了解我国东、中、西部地区社区卫生服务中心基本服务项目开展现况。方法采用自填调查表,调查11个省(自治区)、直辖市200个社区卫生服务中心预防保健、医疗、康复、健康教育、计划生育技术服务等工作开展情况。结果有85.5%的服务中心为居民建立了健康档案,而保健合同签订率仅为53.5%;70.0%的服务中心开展了向上转诊工作,同时,46.0%的机构开展了向下转诊工作;配备康复设备的社区卫生服务中心为56.5%;得到计划生育部门认可的机构达到68.9%;除播放健康教育录像外,其余各种健康教育活动开展率均超过90.0%。结论不同地区社区卫生服务功能面临着不同的问题与挑战;提倡合同规定义务,提高保健合同签订率;双向转诊渠道不通,社区卫生服务中心下转率明显低于上转率;康复服务开展率低,远远不能满足市场需求;临终关怀和精神病管理工作开展率普遍较低。

Objective To understand the developing state of the basic service items in different regions＇ community health service centers. Methods A questionnaire covered 200 - community health service centers from eleven provinces （ or autonomous regions, or municipalities） was carried out. Results It is shown that 85.50 percent community health service centers have set health record for residents, and the proportion of health care contract is 53.50% only; there are 70. 00% of the service centers where referral to the higher level was carried out, and 46. 00% of the service centers where referral to the lower level was carried out; the centers equipped with the appliance for rehabilitation accounted for 56. 50% ; the rate that centers obtain the certification from family planning department was 68.91% ; the proportion of health education development was more than 90%. Conclusion The community health services in different regions are facing different kinds of difficulties and challenges. So it should be encouraged to raise the proportion of concluding health care contracts between community health service organizations and the patients. Two - side referral did not work well, downward referral rate was obviously lower than upward referral rate from community service centers. The rehabilitation service development rate was too lower to meet the demand of market. The developing rates of terminal care and psychotic management in community health service centers were lower generally.