我国县级中医医院卫生服务能力综合评价

Comprehensive evaluation of health service capability in county-level traditional Chinese medicine hospitals in China

目的综合评价我国28个省份县级中医医院卫生服务能力,为促进基层中医药服务能力均衡发展提供参考。方法从《全国中医药统计摘编》和《中国统计年鉴》提取2021年28个省份县级中医医院卫生服务能力相关数据;围绕卫生资源、卫生服务和服务收入3个维度确定12个中医医院卫生服务能力综合评价指标;综合运用熵权TOPSIS法和秩和比法确定各指标权重,计算评价对象与最优方案的接近程度(C值),并对各省份县级中医医院卫生服务能力进行排序和分档。结果中药饮片收入占药品收入比例(0.628)和每千人口中医类医院机构数(0.057)指标的权重较大,是评价县级中医医院卫生服务能力的关键指标。28个省份县级中医医院卫生服务能力平均C值为0.105,其中,排名前5的省份分别是青海(0.879)、河南(0.128)、四川(0.118)、浙江(0.112)和湖南(0.102);根据最佳分档原则,可将各省份县级中医医院卫生服务能力分为"强""较强""一般""较弱""弱"5档,其中,处于强档的省份为四川、河南和青海。结论我国县级中医医院卫生服务能力总体不高,各省份之间的差距较大,受少数中医特色指标影响较大。建议县级中医医院应强化政府主导作用,以自身中医特色为引领,合理整合医疗卫生资源,切实提升医院卫生服务能力。

Objective To comprehensively evaluate the health service capability of county-level traditional Chinese medicine(TCM)hospitals in 28 provinces of China,for references for improving the balanced development of grassroots TCM services.Methods Data on the health service capability of county-level TCM hospitals in 28 provinces in 2021 were extracted from the National Statistical Extracts of TCM and the China Statistical Yearbook.Based on the three dimensions of health resources,health services and service income,12 comprehensive evaluation indicators of health service ability of county-level TCM hospital were determined.The entropy weight TOPSIS method and rank sum ratio method were comprehensively used to determine the weight of each index,calculate the proximity between the evaluation object and the optimal plan(C value),and sort and grade the health service ability of county-level TCM hospitals of each province.Results The proportion of TCM decoction pieces income in drug income(0.628)and the number of TCM hospital institutions per thousand population(0.057)were the key indicators to evaluate the health service ability of county-level TCM hospitals.The average C value of health service capability of county-level TCM hospitals in 28 provinces in China was 0.105,among which the top 5 provinces were Qinghai(0.879),Henan(0.128),Sichuan(0.118),Zhejiang(0.112)and Hunan(0.102).According to the best classification principle,the health service capability of county-level TCM hospitals in each province can be divided into five grades,including strong,strong,general,weak and weak,among which the provinces in the strong grade were Sichuan,Henan and Qinghai.Conclusions The overall health service capacity of county-level TCM hospitals in China was not high,and there were significant differences between provinces.The health service capacities of county-level TCM hospitals were greatly influenced by a few TCM characteristic indicators.It was suggested that county-level TCM hospitals should strengthen the government′s leading role,take their own TCM characteristics as the guide,reasonably integrate medical and health resources,and effectively enhance their health service capabilities.