江苏省基本公共卫生服务存在的问题及对策研究

A Qualitative Study on the Issues Existing in Implementation of Essential Public Health Service in Jiangsu Province

目的探讨国家基本公共卫生服务项目在江苏省实施过程中面临的问题,提出相应对策。方法采用多阶段分层抽样的方法,于2017年8—9月对江苏省苏南、苏中、苏北三个地区36家基层卫生机构的管理者和服务提供者533人开展专题小组访谈,访谈录音整理后采用内容分析法进行分析。结果基本公共卫生服务项目在实施过程中主要面临人力资源短缺、信息化建设滞后、部分项目服务能力不足、考核和激励机制有待完善、公众认知不够及部门配合欠缺等问题。结论江苏省基本公共卫生服务要向高质量迈进,还需进一步完善管理和运行机制。应加强基层卫生服务人员素质和能力建设、完善信息化平台、改革考核监管机制、加强宣传合作,推进基本公共卫生服务均等化。

Objective To explore the problems existing in the implementation of the national essential public health service in Jiangsu province and to propose corresponding countermeasures. Methods Using a stratified multi-stage sampling method,we recruited 533 institutional managers and healthcare providers from 36 community health care centers and village clinics in Jiangsu province during August and September 2017.They were interviewed using a focus group discussion method.The interviews were audio-taped,transcribed and analyzed using the thematic content analysis. Results The implementation of essential public health service was facing with problems such as shor -tage of human resources,lagging in information construction,inadequate project service capabilities,lacking of project assessment and incentive mechanism,lowering public awareness and lacking of interdepartmental coordination. Conclusion In order to pursue high quality essential public health services,we need to further improve the management and operation mechanism.To promote the equalization of essential public health services,the government should take effective measures to strengthen the quality and capacity building of primary health care workers,perfect the information platform,reform the evaluation and incentive mechanisms and promote propaganda and department cooperation.