健康管理视角下供给层面村卫生室健康服务项目研究

Health Care Service Projects of Village Clinics from Supply Level under the Health Management Perspective

目的在健康管理视角下,从供给层面界定村卫生室健康服务项目,为相关研究及政策的制定提供依据,以改进、完善村卫生室健康服务项目内容。方法于2011年8月10—25日,在山东省随机抽取1个发达地区（市）,采用分层随机抽样方法,根据经济文化发展状况把所辖县分为发达、中等、欠发达三层,每层随机抽取一个县,共抽取3个县;各县按同样的方法把所辖乡镇分为三层,每层随机抽取一个乡镇,共抽取9个乡镇;各乡镇再按同样的方法把所辖村分为三层,每层随机抽取一个村,共抽取27个村。对27个村的村卫生室进行现场调研;根据研究目的,在抽取的9个乡镇的卫生院中,选取3位乡镇卫生院负责人,在抽取的27所村卫生室中,选取6位村卫生室负责人和17位医务人员,共计26人,进行深入访谈;采用Delphi法给出专家认为村卫生室各供给项目开展的重要性程度。通过Epi Data 3.0软件建立数据库并录入数据,利用SPSS 17.0统计软件、采用流行病学统计方法进行数据分析。结果对于村卫生室实际提供项目及其提供程度,有3项服务项目供给程度达到100.0%,13项服务项目供给程度在50.0%及以上,9项服务项目供给程度在8.0%~40.0%。结论村卫生室健康服务项目的供给达到了一定程度,但整体服务能力仍然偏低。建议村卫生室引入健康管理理念,完善、优化村级健康服务项目;加强宣传,深入、连续、全面地开展健康服务;进一步完善供给功能,优化卫生资源配置,提高资源利用率。

Objective This study researched on the village clinic health service in supply level under the health management perspective so as to provide certain reference for related research and policy-making for its further improvement and perfection. Methods From 10 to 25 of August,2011,one developed district（ city） was randomly selected from Shandong and by multi stage stratified sampling method the countries in the district were divided into three levels： developed,secondary developed,underdeveloped according to the economic and cultural development, from each one county was chosen. With the same method,the towns in each level of the counties were divided into another three levels,from each one town was selected and then one village from each town,so we got 27 villages from 9 towns all together and did spot investigation of the clinics in the villages and in-depth interview of 26 people including 3 in charge of the town clinics out of the 9 towns,6 in charge of the village clinics and 17 medical workers out of the 27 village clinics. The degree of importance of each supply project of village clinic was determined by using Delphi method. Database was established and data were input by Epi Data 3. 0 and data analysis was made by SPSS17. 0 and epidemic statistics method. Results According to data provided by the clinics,the supply extent of three projects was up to 100. 0%,of 13 supply projects up to 50. 0% and of 9 projects up to 8. 0% ~ 40. 0%. Conclusion Although the supply of Health services project of village clinics has achieved a certain level,the Overall service capacity is still low. It is suggested that the concept of health management should be introduced to improve and optimize the village health service projects; strengthen publicity and develop the health services more deeply,continuously,and comprehensively; further perfect the supply capacity,optimize the allocation of health resources and improve the efficiency of resource utilizing.