贫困地区县级公立医院医疗服务能力发展现状及改进策略研究:以三峡城市群县级公立医院发展为例

The current situation and improvement strategy of healthcare capability of county-level public hospitals in poverty areas-A case study of county-level public hospitals in Three Gorges urban agglomeration

目的:通过了解和分析2011-2015年以三峡城市群为代表的贫困地区县级公立医院医疗服务能力建设情况和发展趋势,为进一步深化医药卫生体制改革,提升贫困地区医疗服务能力,推动"健康扶贫"政策提供参考。方法:利用描述性统计分析方法和Malmquist资源分析方法对样本地区县级公立医院基本情况与医疗服务提供和资源利用现状进行研究,探讨贫困地区县级公立医院医疗服务能力发展现状。结果:在医院规模、医疗服务提供和服务效率等方面,医院通过近几年的改革和自身发展,取得了一定的提升;但诊疗水平和服务安全性方面的工作仍有待提高。同时医院由于创新动力不足,技术进步和诊断水平提升受限制,导致医院资源利用能力不升反降,发展后劲不足。结论:应重点加强医院创新能力建设,通过人才引进和医疗知识更新等方式,激发个人和组织的学习、创新热情,助推医院医疗服务能力建设。

Objectives： To understand and analyze the situation and development trend of medical care capacity construction in county-level public hospitals in poverty-stricken areas which are represented by the Three Gorges urban agglomeration in 2011-2015 and to give reference for decision making on further deepening the reform of healthcare, promoting medical capacity in poverty-stricken areas and ＂Health poverty alleviation＂. Methods： The descriptive statistical analysis method and Malmquist resource analysis method were used to study the basic situation of medical institutions and the current situation of medical service provision and resource utilization in the sample counties. The current situation of the development of medical service ability in county hospitals in poor areas was discussed. Results： In terms of hospital size, medical service provision and service efficiency, the hospital has achieved some improvement through the reform and its own development in recent years. However, the work of the level of treatment and service security still needs to be improved. At the same time the hospital due to lack of innovation power, technological progress and improve the level of diagnosis is limited, resulting in hospital resources utilization capacity does not rise and fall, the development potential is insufficient. Conclusion： The results showed to the government and hospital manager that they should focus on strengthening the construction of hospital innovation ability, through the introduction of talent and medical knowledge update, etc., to stimulate individual and organizational learning, innovation enthusiasm, boost the hospital medical service capacity building.