Study on The Basic Public Health Service in Shanghai

It is increasingly found that medical investment is not the only effective means to improve the national health level. The basic public health service, which is dominated by disease control and prevention, is paid more and more attention.This paper analyzes the relationship between the migrant population and the population of the city＇s household registration to the basic public health service. Access to basic public health services and satisfaction of the system, analysis of the factors affecting the satisfaction of the basic public health services in Shanghai revealed the problems and causes of development. Finally, putting forward the concrete countermeasures and suggestions for perfecting and improving the basic public health service in Shanghai.

基本公共卫生服务效率及其影响因素

目的基于2017年武汉市13个地区基层医疗卫生机构的横断面数据,分析武汉市基本公共卫生服务效率及其主要影响因素。方法采用松弛测度(slack-based-measure,SBM)-超效率数据包络分析(data envelopment analysis,DEA)模型,对武汉市基本公共卫生服务效率进行测算,通过Tobit回归分析进一步探讨其影响因素。结果2017年武汉市13个地区基本公共卫生服务的超效率、纯技术效率、规模效率几何均数分别为1.073、1.213、0.884。其中76.9%的地区为DEA有效,若非DEA有效地区能达到DEA有效,全市可少开办11家基层医疗卫生机构、减少1451张病床、节省6983万元基本公共卫生服务补助经费。60岁及以上老年人比例、平均期望寿命、每千人口卫生技术人员数、每千人口床位数对武汉市基本公共卫生服务效率的影响具有统计学意义。结论武汉市基本公共卫生服务效率地区差异较大,规模效率是制约基本公共卫生服务效率的关键因素。60岁及以上老年人比例越高、平均期望寿命越长、每千人口卫生技术人员数越多,基本公共卫生服务效率越低;每千人口床位数越多,基本公共服务效率越高。针对这些因素,需提高老年人健康管理水平,优化机构人员配置,合理调整机构规模,重视基本公共卫生服务的公益性。