贵阳市农村基层医疗卫生机构服务能力评价研究

Evaluation of service capacity of rural primary health care institutions in Guiyang Province

目的对贵阳市10个区(市/县)农村基层医疗卫生机构的服务能力进行评价,为卫生行政部门制定决策、精准化提升服务能力提供科学依据。方法以2020年贵阳市卫生统计数据为基础,从医疗卫生人力资源、服务设施和服务效益3个维度共10个指标,运用熵权—TOPSIS法对贵阳市6区3县1市农村基层医疗卫生机构服务能力进行分析与评价。结果在各项指标中,农村基层医师日均担负入院人数指标权重最大,为0.1300,每万农村人口拥有农村基层万元以上设备数指标权重最小,为0.0752;贵阳市农村基层医疗卫生机构综合服务能力排名前3名的地区为修文县、开阳县和观山湖区,后3名的地区为乌当区、花溪区和白云区;贵阳市西北方向地区综合服务能力总体高于贵阳市东南方向地区。结论贵阳市农村基层医疗卫生机构服务能力存在区域间差异,各维度医疗卫生服务能力发展存在不同步现象。贵阳市应当科学评估建机制,精准施策助力服务能力均衡发展;内外合力补短板,有效推进农村基层首诊秩序运行。

Objective To evaluate the service capacity of rural primary health care institutions in 10 districts(cities/counties) of Guiyang City, so as to provide scientific basis for health administrative departments to make decisions and improve service capacity accurately. Methods On the basis of the health statistical data of Guiyang in 2020, the service capacities of rural primary health care institutions in 6 districts, 3 counties and 1 city of Guiyangwere analyzed and evaluated by entropy-TOPSIS method from three dimensions of medical and health human resources, service facilities and service benefits, which covered 10 indexes. Results Among all the indexes, the weight of the average daily number of hospitalizations undertaken by rural grass-roots doctors was the largest, which was 0.130 0, and the weight of the number of equipment with more than 10 000 yuan per 10000 rural population was the smallest, which was 0.075 2;Xiuwen County, Kaiyang County and Guanshanhu District ranked the top three in the comprehensive service capacity of rural primary health care institutions in Guiyang, while Wudang District, Huaxi District and Baiyun District ranked the bottom three;The comprehensive service capacity in the northwest of Guiyang was generally higher than that in the southeast of Guiyang. Conclusions There are regional differences in the service capacity of rural primary health care institutions in Guiyang, and the development of health care service capacity in all dimensions is not synchronized. In Guiyang it is necessary to scientifically evaluate and build mechanisms, accurately implement policies and help the balanced development of service capacity;meanwhile, internal and external efforts should be joined togetherto make up for the weaknesses and effectively promote the orderly operation of first-diagnosis responsibility system in rural primary health care institutions.