恩施州乡镇卫生院卫生服务能力的现状调查与分析

Investigation and Analysis on the Current Situation of Health Service Capacity of Township Hospitals in Enshi Prefecture

目的 解决制约影响恩施州基层医疗卫生服务水平向高水平和均等化发展的障碍,为恩施州乡镇基层医疗卫生机构诊疗水平的现状和发展做出预估,并为其医疗水平的建设与提高提供合理建议。方法 抽取恩施州4个县市8个乡镇卫生院进行现场调查,对乡镇卫生院负责人进行访谈,同时对卫生院医务人员、就医患者及当地居民进行问卷调查,用Excel软件建立数据库,进行数据双录入和逻辑检查。采用SPSS 22.0软件对数据进行统计分析。结果 医院床位的实际使用率常常低于50%;医务人员年龄21~40岁之间占63.13%;大专学历占40.42%,本科学历占43.87%;健康扶贫985政策中农村贫困人口报销比例到80%以上;被调查的乡镇卫生院盈余仅占1/3;医生所接诊患者的医疗常识仅12.30%很了解;年龄大、受教育程度低、农村人口在基层卫生院就医的占50%以上;居民对乡镇卫生院整体满意度达到76.5%。结论 国家非常重视对基层医疗的投入,但是卫生资源的分配、医学人才的培养、医保的管理制度等政策还不够完善,乡镇卫生院负债较重,患者的医疗常识不够。乡镇卫生院还需要合理分配资源、完善各项制度、通过人群定位和分项精准管理等不断推进基层卫生医疗机构服务水平的提升,促进我国基层卫生事业的发展。

Objective To solve the obstacles that restrict the development of Enshi's primary medical and health services to a high level and equalization,to make an estimate of the current situation and development of the diagnosis and treatment level of Enshi's township primary medical and health institutions,and to provide reasonable suggestions for the construction and improvement of their medical level.Methods Eight township hospitals in four counties and cities in Enshi were selected for on-site investigation,and the heads of township hospitals were interviewed.At the same time,a questionnaire survey was conducted among medical staff,patients and local residents.Excel software was used to establish a database for data double entry and logical inspection.SPSS 22.0 software was used for statistical analysis of the data.Results The actual utilization rate of hospital beds was often less than 50%;the age of medical staff between 21-40 years old accounted for 63.13%;college education accounted for 40.42%,undergraduate education accounted for 43.87%;in the health poverty alleviation 985 policy,the proportion of rural poor people's reimbursement was more than 80%;the surplus of township hospitals surveyed accounted for only 1/3;only 12.30%of the doctors knew the medical knowledge of the patients.More than half of the rural population were older,less educated,and more than half of the rural population seek medical treatment in primary health centers;residents'overall satisfaction with township hospitals reached 76.5%.Conclusion The state attaches great importance to the investment in primary health care,but the allocation of health resources,the cultivation of medical talents,the management system of medical insurance and other policies are not perfect enough,the township hospitals are heavily indebted,and the patients'medical knowledge is not enough.Township hospitals also need to rationally allocate resources,improve various systems,and continuously promote the improvement of the service level of primary health care institutions through population positioning and precise management of sub-items,so as to promote the development of primary health care in China.