广西两县卫生服务整合及其影响因素研究

Study on integration and influential factors of health services in two counties of Guangxi

目的:从医疗卫生服务提供者视角对两县的医疗卫生服务体系县域内整合现状进行评价和分析并提出相应的政策建议。方法:以卫生服务整合理论为基础、选取彩虹模型作为分析框架,将彩虹模型量表得分进行百分制转化进行描述性分析和回归分析。结果:两试点县在以人和社区为中心和机构文化两个维度得分较高,其次是服务整合和技术能力,在组织整合维度得分较低,专业整合维度得分最低。其中,县医院在以人和社区为中心、服务整合、专业整合和机构文化四个维度得分最高,公共卫生机构在这四个维度得分最低;基层医疗机构在技术能力维度得分最高。医疗机构的各维度的整合服务评分与医务人员的学历、是否全科医生和职工满意度有关。结论:县域医疗机构要以政府为主导,完善基层人才培养体系,从而落实县域医共体建设,推动医防融合,以进一步提高医疗机构服务整合程度,增强医务人员满意度。

Objective:To evaluate and analyze the current situation of the integration of the medical and health service system in the two counties from the perspective of medical and health service providers,and to put forward corresponding policy suggestions.Methods:Based on the integration theory of health services and Rainbow Model,descriptive analysis and regression analysis are conducted after converting Rainbow Model scale scores into percentage.Results:The two pilot counties scored relatively high in people-and-community-centered concept and institutional culture,second high in competence of nursing collation and technics.They scored fairly low in organizational integration and the lowest in professional integration.Among all parties assessed,county hospitals scored the highest in the above four dimensions,while public health institutions scored the lowest;and primary medical care institutions scored the highest in the dimension of technical competence.It is also found that the scores gained by those medical care providers are related to the academic qualifications of medical staff,percentage of general practitioners and employee satisfaction.Conclusion:County medical institutions should be under the leadership of the government and improve their fundamental staff-training system,so as to implement co-construction of county medical community and promote the integration of medical care and prevention to further upgrade integration of medical institutions and enhance employee satisfaction of medical personnel.