分级诊疗制度下安徽省基层医疗卫生机构服务能力评价

Evaluation of service ability of primary health care institutions in Anhui Province under Hierarchical Medical System

目的:对安徽省实施分级诊疗制度下基层医疗机构服务能力进行评价,并提出有效对策。方法:采用熵权-TOPSIS法与秩和比(RSR)法综合评价2015-2020年安徽省各市基层医疗卫生机构服务能力。结果:2015-2020年安徽省皖北、皖中和皖南地区基层医疗卫生机构服务能力综合评价平均水平分别为0.556、0.310、0.139;RSR法分档结果为好(C_(i)>0.542)、中(0.092<C_(i)<0.542)、差(C_(i)<0.092)三类。方差分析结果显示,F=74.77225,P<0.001,说明分档结果具有统计学意义。结论:安徽省各市基层医疗卫生机构服务能力在分级诊疗制度的作用下有所改善,但明显存在地区差异。政府应发挥主导作用,继续加大对基层医疗机构软硬件的投入,缩小基层医疗卫生机构服务能力配置差异,平衡各区发展;加强人员培养,完善人才激励机制,提高整体服务能力水平。

Objective:To evaluate the service ability of the grassroots level care institutions under the hierarchical diagnosis and treatment system in Anhui Province and put forward effective countermeasures.Methods:Entropy weight-TOPSIS method and rank-sum ratio(RSR)method were used to comprehensively evaluate the service ability of the grassroots level care institutions in Anhui Province from 2015 to 2020.Results:According to the entropy weight-TOPSIS method,the average comprehensive evaluation of service ability of the grassroots level care institutions in northern,central and southern Anhui from 2015 to 2020 were 0.556,0.310 and 0.139.The results of RSR method grading were good(C_(i)>0.542),medium(0.092<C_(i)<0.542)and poor(C_(i)<0.092).The analysis of variance showed that:F=74.77225,P<0.001,indicating that the results were statistically significant.Conclusion:The service ability of the grassroots level care institutions in Anhui Province has been improved under the effect of hierarchical diagnosis and treatment system,but there are obvious regional differences.The government should play a leading role,continue to increase investment in hardware and software of the grassroots level care institutions,narrow the differences in service capacity allocation of the grassroots level care institutions,and balance the development of various regions;strengthen personnel training,improve the talent incentive mechanism,improve the overall service ability level.