不同体制社区卫生机构完成基本公共卫生服务现状分析

Analysis on current situation of implementing basic public health services by community health institutions with different ownership

目的比较深圳市罗湖区公立、民营社区卫生机构公共卫生服务运行现状,分析二者各自的优势和问题,为卫生行政部门决策提供参考。方法对罗湖区34家社区健康服务中心在岗的375名医务人员,从人员配置、公共卫生服务开展等方面进行问卷调查,并通过国家基本公共卫生服务项目数据填报系统对公共卫生服务项目的数量、质量指标进行分析。率的比较采用χ^2检验。结果罗湖区民营社区健康服务中心的医务人员高年龄组、高职称和高学历的构成比均低于公立社区健康服务中心,差异有统计学意义(P<0.05)。调查对象每周开展全科诊疗及公共卫生服务工作的时间均值分别为(30.8±11.5)小时和(19.7±13.2)小时,共有73.9%的人兼职开展基本公共卫生服务。与公立社区健康服务中心相比,民营社区健康服务中心参与基本公共卫生服务的医务人员构成比较低(民营68.7%vs公立80.1%),但每周工作时间超过40小时者构成比更高(民营79.3%vs公立36.7%),差异均有统计学意义(P<0.05);民营社区健康服务中心医务人员在老年人群、高血压患者和2型糖尿病患者规范管理完成率方面高于公立社区健康服务中心,差异均有统计学意义(P<0.05)。结论罗湖区民营社区健康服务中心的人力资源配置有待加强,但在某些重点人群健康管理方面具有一定优势。

Objective To compare the operational situation in public health services between public and private community health institutions in Luohu District of Shenzhen, and to analyze their own advantages and problems and to provide reference for health administrative departments to make decisions. Methods A total of 375 medical staff from 34 community health service centers in Luohu District were investigated by questionnaires, which contained the contents of human allocation, the development of public health services and so on. The quantity and quality index of public health service items were analyzed through the report forms system of national primary public health service items. Chi-square test was used for comparing the rates. Results The constituent ratios of high-age group, high-title group and high-level education group in private community health service institutions were all lower than those of public community health service centers, and the differences were statistically significant(P<0.05). The average time of medical staff to conduct general practice and public health services per week was(30.8±11.5) hours and(19.7±13.2) hours, respectively, and a total of 73.9% of the respondents carried out basic public health services part-time. Compared with public community health service centers, the constituent of medical staff participating in basic public health services in private community health service centers was lower(68.7% in private vs 80.1% in public), but the ratio of the staff working more than 40 hours a week was higher(79.3% in private vs 36.7% in public), and the differences were statistically significant(P<0.05);the completion rates of standardized management in the elderly, hypertension patients and 2-type diabetes patients by medical staff in private community health service centers were higher than that in public community health service centers, and the differences were statistically significant(P<0.05). Conclusion The human resource allocation of private community health service centers in Luohu District needs to be strengthened. But they also have certain advantages in health management of some target groups.