학술논문
城市社区卫生服务中心发展情况调查研究 / Survey Research on the Development of Urban Community Health Service Centers
Document Type
Academic Journal
Author
李娅玲; 顾燕峰; 郑艳玲; 蔡学民; 王伟; 余海燕; 杜兆辉; LI Yaling; GU Yanfeng; ZHENG Yanling; CAI Xuemin; WANG Wei; YU Haiyan; DU Zhaohui
Source
中国全科医学 / Chinese General Practice. 27(10):1166-1172
Subject
Language
Chinese
ISSN
1007-9572
Abstract
背景 我国城市社区卫生服务中心发展近 20 年,但有关其发展情况、取得的进展及存在的问题等缺乏系统性研究.目的 通过分析我国城市社区卫生服务中心发展情况,为推动其高质量发展提供参考.方法 课题组于 2022 年 10 月采用便利抽样法在东、中、西部 13 个省份选出 50 家社区卫生服务中心,并以城市社区卫生服务中心考核的关键核心指标为基础自制调研问卷.调研问卷分为基础数据和评估内容两部分:基础数据包括辖区面积、职工人数、门诊人次数等;评估内容包含 4 项Ⅰ级指标(机构设置、服务功能、服务方式、服务支持)、13 项Ⅱ级指标及33项Ⅲ级指标.选取2006年或建院首年的数据和2021年的数据进行对比,通过"问卷星"上报调研结果.结果 (1)基本数据:社区卫生服务中心建院时间在 2006 年之前的有 24 家(48.00%),在 2006 年之后的有 26 家(52.00%).2006 年或建院首年、2021 年职工人数分别为 67.00(40.00,101.00)人、94.00(62.00,162.00)人;门诊人次数分别为 39 324.00(22 620.00,118 384.00)人次数、106 259.00(44 999.00,225 851.00)人次数;调研问卷总分分别为36.50(28.13,46.00)分、69.00(56.38,76.00)分.(2)Ⅰ级指标"机构设置""服务功能""服务方式""服务支持"2021 年中位数得分均高于 2006 年或建院首年,不同年份数据比较,差异有统计学意义(P<0.05).2021 年相对得分率分别是"机构设置"[77.27%(25.50/33.00)],"服务功能"[61.84%(23.50/38.00)],"服务方式"[76.92%(10.00/13.00)],"服务支持"[47.37%(9.00/19.00)]."机构设置"中"建筑面积"中位数得分均为0分."服务功能"中"社区常见病、多发病和慢性病诊治""住院服务内容"相对得分率均为 100.00%;"住院床位使用率"相对得分率均为25.00%(1.00/4.00).(3)服务功能、服务方式及服务支持的Ⅱ、Ⅲ级指标得分:"服务功能"中"公共卫生项目"中位数得分从 2006 年或建院首年的 2.00 分上升到 2021 年的 9.50 分,不同年份数据比较,差异均有统计学意义(P<0.05),其 2021 年相对得分率为 59.38%(9.50/16.00)."服务方式"中"资源整合"相对得分率 2021年为100.00%."服务支持"中"全科医师""公共卫生医师"、"科研任务"中位数得分均为0分,"全科医师""科研任务"不同年份数据比较,差异均有统计学意义(P<0.05).结论 城市社区卫生服务中心的持续发展在机构设置、服务功能、服务方式、服务支持相对得分率的逐步提升方面有所体现.建筑面积、住院服务能力、人员配比严重不足等问题导致服务能力增长缓慢,已成为社区卫生服务中心发展的掣肘问题.
Background The urban community health service centers in China have developed for nearly 20 years,but there is a lack of systematic research on their development,progress made,and existing problems.Objective To propose suggestions for the high-quality development of urban community health services centers in China by analyzing their development situation.Methods In October 2022,50 community health service centers were selected from 13 provinces in the eastern,central and western regions by convenience sampling method.A self-developed research questionnaire based on the key core indicators for the assessment of urban community health services centers included two parts of basic data and evaluation content.Basic data included jurisdictional area,number of employees,number of outpatient visits,etc;the evaluation content included 4 grade Ⅰ indicators(institutional configuration,service function,service mode,and service support),13 GradeⅡindicators and 33 GradeⅢindicators.The data of year 2006(or the first year of the hospital's establishment and data)and 2021 were compared,and the survey results were reported in through"sojump".Results(1)Basic data:the number of community health service centers established before 2006 were 24(accounting for 48.00%),and 26 after 2006(accounting for 52.00%);comparing the year of 2006 or the first year of establishment,and the year of 2021,the number of employees was 67.00(40.00,101.00)and 94.00(62.00,162.00)respectively;the number of outpatient visits was 39 324.00(22 620.00,118 384.00)and 106 259.00(44 999.00,225 851.00)respectively;the total score of the questionnaire was 36.50(28.13,46.00)and 69.00(56.38,76.00),respectively.(2)The median scores of Grade I indicators institutional configuration,service mode and service function in 2021 were all higher than those in 2006 or the first year of establishment.The relative scoring rate of Grade I indicators in 2021,institutional configuration was 77.27%(25.50/33.00),service mode was 61.84%(23.50/38.00),service function was 76.92%(10.00/13.00),service support was 47.37%(9.00/19.00).The median score of structure area in the institutional configuration indicators was 0;among the service function indicators,the relative scoring rate of the diagnosis and treatment of common and chronic diseases in the community,and the inpatient service content were all 100.00%;the relative scoring rate of inpatient bed utilization rate was 25.00%(1.00/4.00).(3)Score of GradeⅡ、Ⅲ evaluation indicators of service function,service mode,and service support:The median score of public health items in service function increased from 2.00 points in 2006 or the first year of establishment to 9.50 points in 2021.The differences were statistically significant(P<0.05)in different years,with a relative scoring rate of 59.38%(9.50/16.00)in 2021;the relative scoring rate of resource integration in service mode was 100.00%in 2021.Among the service support indicators,the median scoring of general practitioners,public health practitioners and scientific research tasks all were 0;there was statistically significant difference(P<0.05)in the distribution of scores of general practitioners and scientific research tasks in different years.Conclusion The sustainable development of urban community health service centers is reflected in the gradual improvement of the relative scoring rate of institutional configuration,service function,service mode and service support.But the area of structure,inpatient service capacity and personnel ratio are seriously insufficient and the growth is very slow,which has become a constraint on the development of community health service centers.
Background The urban community health service centers in China have developed for nearly 20 years,but there is a lack of systematic research on their development,progress made,and existing problems.Objective To propose suggestions for the high-quality development of urban community health services centers in China by analyzing their development situation.Methods In October 2022,50 community health service centers were selected from 13 provinces in the eastern,central and western regions by convenience sampling method.A self-developed research questionnaire based on the key core indicators for the assessment of urban community health services centers included two parts of basic data and evaluation content.Basic data included jurisdictional area,number of employees,number of outpatient visits,etc;the evaluation content included 4 grade Ⅰ indicators(institutional configuration,service function,service mode,and service support),13 GradeⅡindicators and 33 GradeⅢindicators.The data of year 2006(or the first year of the hospital's establishment and data)and 2021 were compared,and the survey results were reported in through"sojump".Results(1)Basic data:the number of community health service centers established before 2006 were 24(accounting for 48.00%),and 26 after 2006(accounting for 52.00%);comparing the year of 2006 or the first year of establishment,and the year of 2021,the number of employees was 67.00(40.00,101.00)and 94.00(62.00,162.00)respectively;the number of outpatient visits was 39 324.00(22 620.00,118 384.00)and 106 259.00(44 999.00,225 851.00)respectively;the total score of the questionnaire was 36.50(28.13,46.00)and 69.00(56.38,76.00),respectively.(2)The median scores of Grade I indicators institutional configuration,service mode and service function in 2021 were all higher than those in 2006 or the first year of establishment.The relative scoring rate of Grade I indicators in 2021,institutional configuration was 77.27%(25.50/33.00),service mode was 61.84%(23.50/38.00),service function was 76.92%(10.00/13.00),service support was 47.37%(9.00/19.00).The median score of structure area in the institutional configuration indicators was 0;among the service function indicators,the relative scoring rate of the diagnosis and treatment of common and chronic diseases in the community,and the inpatient service content were all 100.00%;the relative scoring rate of inpatient bed utilization rate was 25.00%(1.00/4.00).(3)Score of GradeⅡ、Ⅲ evaluation indicators of service function,service mode,and service support:The median score of public health items in service function increased from 2.00 points in 2006 or the first year of establishment to 9.50 points in 2021.The differences were statistically significant(P<0.05)in different years,with a relative scoring rate of 59.38%(9.50/16.00)in 2021;the relative scoring rate of resource integration in service mode was 100.00%in 2021.Among the service support indicators,the median scoring of general practitioners,public health practitioners and scientific research tasks all were 0;there was statistically significant difference(P<0.05)in the distribution of scores of general practitioners and scientific research tasks in different years.Conclusion The sustainable development of urban community health service centers is reflected in the gradual improvement of the relative scoring rate of institutional configuration,service function,service mode and service support.But the area of structure,inpatient service capacity and personnel ratio are seriously insufficient and the growth is very slow,which has become a constraint on the development of community health service centers.