拉萨市社区卫生服务中心资源配置现状调查

A cross-sectional study on health resource allocation in community health service centers in Lhasa City,Tibet,P. R. China

目的:了解和分析拉萨市目前所有社区卫生服务中心的资源配置情况和存在的问题,为完善拉萨社区卫生服务中心资源配置提供理论依据。方法:采用普查法,对拉萨市所有社区卫生服务中心进行了现场调查,将数据录入SPSS 17. 0,进行了描述性分析。结果:拉萨市7家社区卫生服务中心均已开展社区首诊制度。在岗人员总数206人,其中在编人员占56. 80%。在岗146名卫生技术人员中,注册护士仅占19. 18%,医护比倒置。卫生技术人员职称偏低,学历以本科为主(占36. 60%)。4家社区卫生服务中心的建筑面积达到国家要求,7家中心的床位数均未达到要求数量。结论:拉萨市社区服务中心资源配置总体情况较好,但存在一些不足:相关政策制度未落实到位,政府缺乏有效监督管理机制;医护比例颠倒,人员学职称普遍偏低,培训力度不够。

Objective To determine the healthcare resource allocation in all 7 community health service centers（CHC） in Lhasa City,and to analyze the current issues of CHC resource allocation,aiming to provide the evidence for the improvement of the health resources of CHC in Lhasa. Methods A census survey was conducted in all seven CHCs in Lhasa,with an onthe-spot questionnaire survey on the centers＇ geographical location,area,policy implementation,on-the-job staffs,staff training,facility area,equipment configuration,etc. The data were recorded by SPSS 17. 0 and descriptive analysis was conducted. Results All the seven CHCs currently were running as community first visit healthcare center for referral. Totally there were 206 on-the-job staff in those centers,56. 80% of whom were permanent staff. Among 146 health workers,registered nurses accounted for only 19. 18%,hence,doctor nurse ratio was high. Health workers＇ professional title was relatively low,and only 36. 60% of them had college education. Four CHCs＇ building construction area met the national standard,however,the number of all seven centers＇ sickbed did not reach the national standard. Conclusions The overall resource allocation of CHCs in Lhasa City was in a reasonable level,whereas,policy implementation and government effective supervision and management mechanism should be strengthened in future. And more college graduates are needed for the posts of nurses and physicians and vocational training programs should be carried out as a routine training system.