The situation of primary care institutions under the background of new medical reform in China

[目的] 分析新医改背景下我国基层医疗卫生机构的发展现状,探讨存在的问题,为进-步完善基层 卫生事业改革发展提供参考.[方法]利用2008 - 2 0 1 2年中国卫生统计年鉴数据,对基层医疗卫生机构基础设 施、人才配置和卫生服务利用状况进行分析.[结果] 2008 - 2 0 1 2年我国基层医疗卫生机构总数量年平均增速 为 1.55%,其中西部地区的机构数量最少、但年平均增速最快,中部地区的数量比西部多比东部少;在三大基 层医疗卫生机构当中,社区卫生服务中心（ 站）、乡镇卫生院和村卫生室机构数量年平均增长率分别为8 . 4 4 %、 -1.3%和 1.6%; 三大基层机构卫生技术人员数量年平均增长率分别为2 0 . 2 5 %、3% 和 5 . 0 2 % ; 三大基层机构 诊疗人次数年平均增长率分别为2 3 . 6 8 %、3. 96% 和 8. 92 %.截至2 0 1 2年 ,社区卫生服务中心卫生技术人员的 学历以大专为主（占40. 9%）,职称以师级/助理为主 （占32. 8%）; 乡镇卫生院卫生技术人员的学历以中专为 主 （占51. 3%）,职称以士级为主（占40. 2%）.[结论]新医改后我国基层医疗卫生机构发展迅速,但资源分 布仍不均衡;基层卫生技术人员数量不断增加,但学历职称层次仍偏低;基层医疗卫生机构卫生服务利用增 加 ,但患者就医仍缺乏有效引导.

Objective To analyze the situation of primary care institutions under the background of newmedical reform,discuss the problems inorder to provide policy recommendations Sor further improvement. Methods This study used the data o-2012）,and analyzed the infrastructure of primary care institutions,primary care professionals and healtli service utilization. Results From2008 to 2012, the average annual growth rate of total number of primary care institutions was 1. 55 J,and the western area had the lowest num-ber but t!ie highest growt!! rate. The number in central region was larger than the western but less than the eastern area. Among three main pri-mary care institiitions, the average annual growth rate of community health service ccnter,township hospital and village clinic were 8. 44 % 、-1.3% and 1. 6% respectively. Average annual growth rate of primary care professionals were 20. 25 %、3 % and 5. 02 % respectively. Aver-age annual growt!! rate of heaHicare visits per person were 23. 68 %、 3. 9 6 % and 8. 9 2 % respectively. Until 2012, the primary care profession-als in community heaHi service centers mainly had college degree （40. 9% ） and assistant qualification （32. 8% ）,while the primary care pro-fessionals in township hosjDitals mainly had technical secondary school degree （51. 3% ） and staff qualification （40. 2% ） . Conclusions After the new medical reform in China, the primary care institutions developed quickly. But resources were misallocated. The number of primary care professionals increased, but the education and qualification levels were still low. Health services utipatients were lack of effectively guided.