2010年我国基层卫生机构服务功能现状分析

基层医疗卫生机构决定着基本卫生服务的供给。本文利用医改监测项目的面上调查与专题调查数据,对城乡基层卫生机构服务开展情况进行了分析。本研究根据居民主要健康问题、经济发展水平、基层卫生服务机构服务能力,将基本卫生服务项目分为基本医疗服务和基本公共卫生服务,每一类中又分为一级和二级项目。目前我国基层卫生服务机构服务功能总体状况一般,基本公共卫生服务的开展情况(84.8%)好于基本医疗服务的开展(73.7%)。城乡差别不明显。东部的基本医疗服务提供情况明显好于西部。影响基层卫生机构基本医疗服务功能的主要因素为设备缺乏、人员数量及能力缺乏。影响基层卫生机构基本公共卫生服务功能开展的主要因素为上级没有要求,上级不允许开展。

The provision of basic health care is largely determined by functions of primary health providers. This paper analyzes the situation of primary health providers using the data from monitoring survey of health reformation and a specific survey. All health services are categorized into two groups according the contents of delivery. The two groups are basic medical care and basic public health care. Each group further categorized into two groups according to their priorities for delivery. Primary care institutes perform not very well in providing basic health care. Compared to providing basic medical care, Primary health providers provide better basic public health care. The gap between rural and urban providers is not big. Institutes in east China perform better than institutes in west China. The deficiency in equipment, human resources, and competency of primary care providers are the major barriers for primary care institutes to provide basic medical care. No request and unallowed from health management department are the major barriers for primary care institutes to provide basic public health care.