乡村振兴背景下湖北省脱贫县乡镇卫生院服务能力综合评价

Comprehensive evaluation of the service capacity of township hospitals in the counties freed from poverty in Hubei province under the background of rural revitalization

目的评价湖北省脱贫县乡镇卫生院的服务能力,为提升脱贫地区乡镇卫生院的服务能力提供参考。方法在文献分析的基础上构建评价指标体系;基于湖北省卫生健康委员会2022年乡镇卫生院绩效考核调查数据,采用熵权-TOPSIS法结合秩和比法对湖北省脱贫县乡镇卫生院的服务能力进行综合评价。结果构建了以基本医疗服务、公共卫生服务、卫生资源、服务效率为一级指标,包含11个二级指标的乡镇卫生院服务能力评价指标体系。最终纳入32个脱贫县的299所乡镇卫生院进行分析,熵权-TOPSIS法的评价结果显示,权重系数最高的一级指标为卫生资源(0.43),二级指标为每乡镇卫生院年均出院患者手术人数(0.17)。32个脱贫县的乡镇卫生院的基本医疗服务、公共卫生服务、卫生资源、服务效率和综合服务能力的Ci值均值分别为0.304、0.420、0.329、0.576和0.352。秩和比法分档结果显示,脱贫县乡镇卫生院服务能力被评为好、中、差者分别有6个、21个和5个。结论脱贫县乡镇卫生院的医疗服务能力相对薄弱,不同脱贫县的乡镇卫生院的服务能力差距明显。脱贫县乡镇卫生院服务能力提升的着力点在卫生资源与手术操作能力。

Objective To evaluate the service capacity of township hospitals in the counties freed from poverty in Hubei province,for reference in improving their service capacity.Methods An evaluation index system was constructed based on literature analysis.The service ability of such hospitals was comprehensively evaluated by both entropy weight-TOPSIS and rank-sum ratio method based on the 2022 performance evaluation data of township hospitals of Hubei Health Commission.Results The evaluation index system of service capacity of township hospitals was constructed,using basic medical service,public health service,health resources and service efficiency as first-level indexes and 11 second-level indexes.A total of 299 township hospitals in 32 such counties were finally included in the analysis,and the results of entropy weight-TOPSIS method showed that the first-level indexes of the highest weight coefficient was health resources(0.43),and the second-level index was annual average number of discharged patients and surgeries in each township hospital(0.17).The mean Ci values of township hospitals in the 32 counties freed from poverty in terms of basic medical services,public health services,health resources,service efficiency,and comprehensive service capacity were 0.304,0.420,0.329,0.576,and 0.352,respectively.The results of RSR method showed that 6,21 and 5 hospitals in such counties were rated as"good,average and poor"in terms of service capacity.Conclusions The medical service capacity of township hospitals was relatively weak,with a clear gap in their service capacity among such counties.The focus of improving their service capacity should be placed on health resources and surgical operation capacity.