江西省卫生服务能力建设工程对乡镇卫生院服务功能开展的影响

Effect of Health Service Capacity Building Project on Development of Service Functions in Township Hospitals in Jiangxi Province

目的探讨江西省卫生服务能力建设工程对乡镇卫生院服务功能的影响,为今后健全和完善乡镇卫生院的服务功能提供依据。方法对2010年1 552所乡镇卫生院采用江西省乡镇卫生院卫生服务能力建设工程终期调查表进行调查。用描述性统计指标对2010年乡镇卫生院工作开展及科室设置情况进行分析,并与2007年的数据进行比较。结果 2010年传染病疫情监测开展率为96.08%、常规免疫接种开展率为94.13%较2007年略有降低(97.19%、95.55%),绝对增加量分别为-1.11%、-1.42%;杀虫、灭鼠开展率为74.48%、碘缺乏病监督监测开展率为69.13%较2007年明显增加(71.27%、64.73%),绝对增加量分别为3.21%、4.40%。2010年健康教育开展率为96.67%、儿童健康检查开展率为94.78%较2007年明显增加(94.04%、90.05%),绝对增加量分别为2.63%、4.73%。但2010年儿童生长监测、体弱儿管理的开展情况不理想(74.48%、69.13%)。2010年内科开展率为100.00%、儿科开展率为100.00%、药房(含中药)开展率为100.00%、妇产科开展率为94.99%、化验室开展率为93.66%、B超开展率为92.95%、发热门诊开展率为92.89%、肠道门诊开展率为90.47%、心电图室开展率为87.47%较2007年明显增加(99.73%、92.21%、98.39%、87.96%、90.84%、82.66%、86.32%、90.45%、80.32%),且均有明显改善。2010年剖腹产开展率为40.60%、胃切除开展率16.06%为较2007年明显降低(46.20%、21.60%),绝对增加量分别为-5.60%、-4.64%,且外科手术的开展总体呈下降趋势。2010年血、尿、便三大常规开展率为92.75%、乙肝表面抗原开展率为85.18%、乙肝二对半开展率为82.31%较2007年明显增加(90.25%、79.91%、77.49%),绝对增加量分别为2.50%、5.27%、4.82%,且整体有上升的趋势。2010年胃肠钡餐造影(18.73%)较2007年(22.19%)明显降低。结论江西省乡镇卫生院服务功能整体工作的开展有显著的改善,基本达到预期的目标,但还存在不足及需改善。

Objective To explore the effect of health service capacity building project on the development of service functions in township hospitals in Jiangxi province,and to provide a scientific basis for improving and perfecting township hospital service functions.Methods An investigation was performed in 1 552 township hospitals in Jiangxi province using the final health service capacity building questionnaire.The situation of work development and department installation in township hospitals in 2010 was analyzed using descriptive statistical indicators,and compared with that in 2007.Results The development rate of infectious disease surveillance was 96.08% in 2010,with a decrease of-1.11% compared with 2007（97.19%）.The development rate of routine immunization was 94.13% in 2010,with a decrease of-1.42% compared with 2007（95.55%）;The development rate of deratization and disinsection was 74.48%,with an increase of 3.21% compared with 2007（71.27%）.The development rate of supervision and monitoring of iodine deficiency disorders was 69.13% in 2010,with an increase of 4.40% compared with 2007（64.73%）.The development rate of health education was 96.67% in 2010,with an increase of 2.63% compared with 2007（94.04%）.The development rate of child health check was 94.78% in 2010,with an increase of 4.73% compared with 2007（90.05%）.The development rates of monitoring of child growth and management of frail children were not satisfactory in 2010（74.48% and 69.13%,respectively）.The development rates of medicine,pediatrics,pharmacies,obstetrics and gynecology,laboratories,B ultrasound,fever clinics,intestinal clinics,and ECG Rooms in 2010（100.00%,100.00%,100.00%,94.99%,93.66%,92.95%,92.89%,90.47% and 87.47%,respectively） significantly increased compared with 2007（99.73%,92.21%,98.39%,87.96%,90.84%,82.66%,86.32%,90.45% and 80.32%,respectively）.The development rates of caesarean section and gastrectomy in 2010（40.60% and 16.06%,respectively） decreased by-5.60% and-4.64% compared with 2007（46.20% and 21.60%,respectively）,and there was a overall downward trend in the development of surgery.The development rate of routine examination of blood,urine and feces was 92.75% in 2010,with an increase of 2.50% compared with 2007（90.25%）.The development rate of hepatitis B surface antigen detection was 85.18%,with an increase of 5.27% compared with 2007（79.91%）.The development rate of hepatitis M detection was 82.31%,with an increase of 4.82% compared with 2007（77.49%）.The development rate of gastrointestinal barium meal examination was 18.73%,with a decrease of 3.46% compared with 2007（22.19%）.Conclusion The health service capacity building project resulted in significant improvement in the development of service functions in township hospitals in Jiangxi province,and the desired objective was almost achieved.However,there were still some deficiencies to be improved.