陕西省卫生管理县镇一体化试点效果分析

Analysis on the effectiveness of the pilot reform of integrating county hospital and township health center in Shaanxi Province

目的:对乡镇卫生院实施卫生管理县镇一体化改革试点一年后的医疗服务运营状况进行评估。方法:选取西安市阎良区2所试点卫生院与4所非试点卫生院为研究对象,以改革试点前后的医疗收入、门诊量等为评估指标进行自身前后对照分析;设计问卷对改革试点医院的医疗管理人员、医务人员及患者进行满意度调查。结果:实施"一体化"改革后,2所试点卫生院的医疗收入及门诊量均显著增加;4所非试点医院的医疗收入和门诊量也有不同程度的波动,但变化特征不明显。被调查人员对改革的满意度高。结论:"一体化"改革显著提升了乡镇卫生院的社会服务职能,有效缓解了农村居民看病难的问题;试点工作为该项改革的全面推进奠定了基础,积累了经验。

Objective： To evaluate the health care service of the township health centers one year after the pilot reform of the integration of county hospital and township health center. Method： 2 experimental hospitals and 4 non-experimental hospitals in Yanliang District of Xi＇an City were chosen to compare medical revenue, outpatients before and after the pilot reform. The hospital managers, the doctors and the patients at the 2 experimental hospitals were surveyed to collect information of their satisfaction. Result： Of two experimental hospitals both the medical revenue and the number of out-patients were increased significantly; while that of the 4 non-experimental hospitals appeared with some variation in terms of satisfaction but the variations had no statistical significance. The persons under investigation tended to report a high level satisfaction of the reform. Conclusion： The reform of the integration promotes the society-serving function of the township health center,while it also alleviates the ＂difficult to see a doctor＂. The experiment gives a sound evidence for overall reform and piles up experience as well.