基于扎根理论的基本公共卫生服务提供质量的影响因素分析

Analysis on the Influencing Factors of the Quality of Basic Public Health Service Provision Based on the Grounded Theory

目的:利用扎根理论探讨基本公共卫生服务提供质量的影响因素,为促进高质量均等化的基本公共卫生服务提供建议与参考。方法:2019年11-12月,采用目的抽样法抽取浙江省、山西省、重庆市进行调查,对3省市的基层医疗机构管理人员进行访谈,并对转录资料进行三级编码分析。结果:通过三级编码抽象出基本公共卫生服务提供重要影响因素9个,并将其归纳为基层公共卫生人力资源、基层医疗卫生机构建设和外部环境3个层面,形成基本公共卫生服务提供影响因素的框架。外部政策环境会影响基层医疗卫生机构建设和基层公共卫生人员现状,二者的能力及水平会直接影响服务项目提供的质量;居民的认知会影响其对基本公共卫生服务的利用。结论:应该增强人员与机构的整体服务能力,建立健全人才引进机制,减轻基层工作负担,加大项目宣传力度。

Objective:To explore the influencing factors of the quality of basic public health service provision based on grounded theory,so as to provide references for high quality and equalization of basic public health service provision.Methods:From November to December 2019,the purposive sampling method was used to select Zhejiang province,Shanxi province and Chongqing municipality.The interviews were conducted among the managers of grassroots medical institutions in the above 3 areas and the three-rank coding analysis was conducted for the data.Results:After three-rank coding,9 important influencing factors of basic public health service provision were generalized and they were categorized into 3 levels including grassroots public health human resources,the construction of grassroots medical and health institutions and external environment.At the last,the whole framework of the influencing factors of basic public health service provision was formed.The external policy environment affected the construction of grassroots medical and health institutions and the status of grassroots public health personnel,and the ability and level of them affected the quality of service provision directly.The cognition of residents affected their utilization of basic public health services.Conclusion:It is recommended to enhance the overall service ability of personnel and institutions,establish and improve the mechanism of talent introduction,reduce the burden of grassroots work and increase the publicity of projects.