深圳市四区社康中心服务供需情况现状分析

Demand and Supply of the Community Health Services in Four Districts of Shenzhen

目的了解深圳宝安区、龙岗区、福田区和罗湖区社康中心卫生服务供给和利用现状,比较社康中心服务存在的问题和差别,为卫生行政部门制定相关政策提供参考依据。方法运用描述性统计方法比较分析深圳市2008—2010年四个区437家社康中心的服务人口、基本医疗和公共卫生服务等情况。结果 2008—2010年宝安区社康中心的服务人口持续高于关内两区,约为福田区和罗湖区的3.16和2.59倍,差异有统计学意义(P<0.01);关内两区门急诊和中医门诊人均可利用次数高于关外;宝安区的门急诊服务人次数和上转人次数均高于其余三区,且上下转人次数之间的差距最大。四区社康中心的健康档案覆盖率下降19.39%～31.20%,关外下降幅度高于关内,其中龙岗区下降幅度最大;宝安区的高血压和糖尿病规范管理人次数低于关内两区,差异有统计学意义(P<0.01)。结论社康中心基本医疗服务与公共卫生服务发展不均衡,关外较关内失衡更严重且卫生服务可及性较差,建议完善管理制度,加大对关外社康中心的财政支持力度。

Objective To investigate the problems of community health service through analyzing the demand and supply of the services in community health centers （CHCs） of Baoan, Longgang, Futian, and Luohu districts in Shenzhen. Methods Descriptive statistical method was used to analyze the served population, medical care, and public services of 437 CHCs of the four districts from 2008 to 2010. Results From 2008 to 2010, the served population of Baoan CHCs was 3.15 and 2. 59 times that of Futian District and Luohu District （P 〈 0. O1 ）. Number of visits per capita at Emergency Room （ER） and Depart- ment of Traditional Chinese Medicine were bigger in Futian District and Luohu District than the other two districts. Baoan District had the highest person - times of ER visit and upward referral, and the largest difference of person - times between upward and downward referral. The health record coverage decreased by 19. 39% - 31.20% with Longgang district having the largest de- crease. The person - time receiving hypertension and diabetes standard management was lower in Baoan District than that in Fu- tian District and Luohu District （P 〈 0. 01 ）. Conclusion The development of medical care and public health service in CHCs are unbalanced, and the situation was worse in Baoan District and Longgang District given their low accessibility. The manage- ment system should be improved and the financial support for the CHCs of Baoan and Longgang should be enhanced.