收支两条线对社区卫生服务机构内部运行机制的作用分析

Analysis of Effect on Internal Operational Mechanism of CHS Facilities by Split and Expenditures

目的了解收支两条线改革对社区卫生服务内部运行机制的影响。方法纵向和横向比较分析试点地区社区卫生服务中心的服务模式和医生行为。结果收支两条线改革改变了社区卫生服务中心的运行机制,机构的服务模式和服务内容发生变化,从以"疾病"为中心改变为以"健康"为中心;医生行为发生改变,主要表现为服务内容改变和行医行为的规范。结论收支两条线能够有效维护社区卫生服务机构公益性。

Objective To learn about the influence of reform of separation from revenues and expenditures on internal operational mechanism. Methods To analysis services models and doctors＇ behaviors in CHS centers in pilot areas comparatively in longitudinal and sectional approaches. Result Reform of separation from revenues and expenditures changed operational mechanism of CHS centers, and services models and Contents changed from diseases-centered model to health-centered model： doctors＇ behaviors changed and besides change of services contents, it embodied in regular medical practice. Conclusion Reform of separation from revenues and expenditures could ensure public welfare of CHC.