天津市基层医疗机构短板问题的分析研究

Analysis and Research on Short Board Problem of Primary Medical Institutions in Tianjin

目的分析天津市基层医疗机构的医疗服务现状、存在问题以及产生问题的原因,以期为政府部门完善管理提供参考依据。方法以天津市基层医疗机构为基础,分析基层医疗机构人员结构,并结合对10 家社区医疗机构医疗技术水平、药品供应、床位及医疗设备使用现状进行调查分析。结果天津市基层医疗机构注册护士的数量仅为全市注册护士的15.74%,突出显示了基层护理人员严重短缺,每千人户籍人口卫生技术人员仅1.94 人,每千人户籍人口执业(助理)医师数1.10 人、注册护士数0.57 人,远低于北京、上海等地。基层医院患者以取药居多,药品不全又得不到患者的满意;大部分设备处于陈旧和老化状态无经济条件更新和维护,因设备简陋检查结果得不到医患的信任;医保报销政策欠完善。结论强化基层医疗机构服务能力建立补齐短板的长效机制,探索建立针对基层卫生机构服务的医保基金使用管理办法。

Objective To analyze the current situation, existing problems and causes of medical services in primary medical institutions in Tianjin, in order to provide reference for improving the management of government departments. Methods Based on the basic medical institutions in Tianjin, this paper analyses the personnel structure of primary medical institutions, and investigates and analyses the current situation of medical technology, drug supply, beds and medical equipment utilization in 10 community medical institution. Results The number of registered nurses in primary medical institutions in Tianjin is only 15.74% of the registered nurses in the whole city, which highlights the serious shortage of primary nursing staff. There are only 1.94 health technicians per 1 000 registered residents, 1.10 medical practitioners per 1 000 registered residents and 0.57 registered nurses, which are much lower than those in Beijing and Shanghai. Most of the patients in primary hospitals take medicine, but the drugs are not enough and can not be satisfied by the patients;most of the equipment is in an old and aging state without economic conditions to update and maintain, because the results of poor equipment inspection can not be trusted by the doctors and patients;and the medical insurance reimbursement policy is not perfect. Conclusion Strengthen the service capacity of grass-roots medical institutions, establish a long-term mechanism to complement the shortcomings, and explore ways to establish the use and management of medical insurance funds for grass-roots health institutions.