北京市乡镇卫生院资源配置基本情况

Basic allocation of health resources in township hospitals in Beijing

该组文章旨在查明北京市乡镇卫生院资源配置的状况，资源利用效率及存在的问题并提出建议，为政府制定政策提供依据。采用文献研究综合归纳的方法形成调查表初稿，采用专家咨询的方法修改完善调查表，采用普查的方法完成对北京市全部189所乡镇卫生院2004年情况的调查，采用统计学的单因素和多因素分析的方法进行统计分析，从性质和数量两方面对统计结果进行解释和讨论。在卫生资源配置上发现的主要问题：一是北京市乡镇卫生院卫生技术人员总体素质并不高，呈现“三多两少”的局面，即年轻人多、低学历人员多、初级人员多，而高学历、高技术职称的人员少；二是部分乡镇卫生院基本人员尚未配齐。在资源利用上的主要发现：一是北京市乡镇卫生院工作开展的很不平衡，各项资源利用效率指标在卫生院间、区县间存在很大差异；二是如果去掉财政补助经费收入，则北京市大多数乡镇卫生院业务收入小于本院总支出。作者就发现的问题进行了讨论，并提出了建议。

The objective of this study was to investigate the status of allocation of health resources and the efficiency of resource use in township hospitals in Beijing, find out the existing problems, and put forward some proposals, thus to provide a basis for the government to formulate the policy. The questionnaire was primarily established by literature research synthesis method, then it was revised and perfected by consulting the experts. General investigation was completed in all the 189 township hospitals in Beijing in 2004. The data were statistically analyzed by methods of single variate analysis and multivariate analysis, and the results were discussed qualitatively and quantitatively. Two major problems in allocation of health resources existed. The first, the overall quality of health professionals in these township hospitals was not high, and the situation of ＂three more, two less＂ was presented, namely, more young personnel, more personnel with low academic qualifications, more junior personnel, less personnel with high academic qualifications, and less personnel with high technical titles. The second, less personnel than basic necessary were staffed in some township hospitals. Two major findings in allocation of resources were as follows. The first, the development of township hospitals in Beijing was hardly even, and there were marked differences in various indicators for the efficiency of resource use between different township hospitals, districts or counties. The second, the operating income in most township hospitals was less than the total hospital expenditure if took out the financial subsidy income. The author discusses on these problems and puts forward the proposals.