基本公共卫生视角下潜江市“医卫结合”模式研究

Evaluation on the “Combination of Basic Public Health Services and Basic Medical Services” Model in Qianjiang City from the Perspective of Basic Public Health

目的:从基本公共卫生角度出发,总结和评价潜江市"医卫结合"模式的工作现状,分析存在的问题,为我国基本公共卫生服务工作的开展提供借鉴。方法:在潜江市选择3个乡镇作为样本地区,对样本地区乡镇卫生院和潜江市卫计委相关人员进行个人访谈,收集基本公共卫生服务工作报表及相关政策文件资料。对定量资料进行描述性统计分析,对定性资料进行逻辑分析。结果:"医卫结合"模式改善了健康档案的管理,提高了重点人群的管理水平,保证了签约服务的可行性,发挥了绩效考核的激励作用;问题主要体现在乡村医生缺乏培训且超编严重,居民对公共卫生服务的参与程度不高。结论:信息系统的应用是"医卫结合"模式的基础,乡村医生的数量和质量是影响"医卫结合"模式运行的重要因素,应探索以提高居民公共健康素养为导向的健康教育活动,"医卫结合"模式中的整合思想有利于改善基本公共卫生服务质量。

Objective： From the perspective of basic public health, to conclude and evaluate the status of ＂ Combination of Basic Public Health Services and Basic Medical Services＂ model, and analyze the existed problems, and provide reference for the development of basic public health services work of our country. Methods： Three towns in Qianjiang was selected as the sample areas; we conducted personal interviews to relevant persons, and collect relevant file data; we used descriptive statistical analysis for quantitative data, and logical analysis for qualitative da- ta. Results： This model improved the level of health records and focus groups management, ensured the feasibility of contracted services, and de- veloped the incentive function of performance evaluation. The problems mainly included that rural doctors lacked training and faced serious over- staff, and the level of residents＇participation into public health services was not high. Conclusion： The application of information system is the foundation of ＂Combination of Basic Public Health Services and Basic Medical Services＂ model, which is influenced by the number and quality of rural doctors. Only we explore the health education activities oriented to improving the residents＇ health literacy, can the integration thought of ＂Combination of Basic Public Health Services and Basic Medical Services＂ model help to improve the quality of basic public health services.