患者视角下的东中西部城市社区卫生综合改革评价  

Comprehensive Reform of Community Health Service in Different Regions in China under Perspective of Patients

作　　者：吴宁[1] 刘涵[2] 张丽芳[1] 刘利群[3] 周巍[3] 王丽坤[2] 刘彩玲[2] 秦江梅[1] 

机构地区：[1]卫生部卫生发展研究中心,北京市100191 [2]石河子大学医学院 [3]卫生部妇幼保健与社区卫生司

出　　处：《中国全科医学》2013年第4期366-369,共4页Chinese General Practice

基　　金：中澳卫生与艾滋病项目(HSS409)

摘　　要：目的从患者的视角，了解我国东、中、西部社区卫生综合改革的变化和社区卫生服务机构的服务提供情况及需要改善的方面。方法按照东、中、西部的地理分布兼顾社区卫生工作基础，选取杭州、无锡、合肥等8个城市，从每个城市中随机抽取12个社区卫生服务中心，对当日门诊患者进行问卷调查。结果（1）西部城市社区就诊患者中反映就医环境、医务人员服务态度、技术水平改善的比例高于东部城市，东部城市患者反映药品价格降低的比例高于中部和西部城市，差异均有统计学意义（P〈0．0125）。（2）西部地区就诊患者对本次服务就医环境、医务人员服务态度和技术水平的满意度分别为88．9％、91．5％和81．6％，高于东中部地区；东部地区患者对本次服务报销比例的满意度为58．5％，高于中西部地区；西部地区患者对药品种类、预防保健服务的满意度分别为51．5％、65．9％，高于东中部地区，差异有统计学意义（P〈0．0125）。（3）关于就诊患者认为社区卫生服务机构需要进一步改善的方面，东部城市排在前三位的依次是：药品种类和质量（25．3％）、药品价格（21．8％）、医疗技术水平（18．2％）；中部城市排在前三位的依次是：基础设施和设备（28．2％）、药品价格（21．8％）、药品种类和质量（21．2％）；西部城市排在前三位的依次是：基础设施和设备（30．8％）、药品种类和质量（28．1％）、医药费用报销的比例和范围（27．9％）。结论各地区应结合就诊患者意愿，进一步推进社区卫生综合改革；继续巩固完善基本药物制度；积极与医保部门合作，共同推进医保支付制度改革。Objective From the perspective of the patents to study the changes of comprehensive reform community health service （CHS） in East, Central and West China, and the service conditions of CHS institutions and the issues that need to be improved. Methods Twelve CHS centers were selected randomly from each of the eight typical cities in East, Central and West China, The questionnaire survey was conducted among patients seeking medical care in these centers that very day. Results （1） The percentage of patients from the West regions who held that there had been improvement in medical surroundings, service attitude and technical skills of the medical staff was higher than that form the East regions ; but the percentage of patients from the East regions who held hat the drug price had lowered was higher than that from the West regions, the differences were of statistical significance （P 〈 0. 0125）. （2） The satisfaction percentages of the patients in the West regions on that very day＇s medical surroundings, service attitude and technical skills of the medical staff were 88.9%, 91.5% and 81.6% respectively, being higher than those in the East and Central regions. The reimbursement satisfaction of the patients in the East regions was 58.5%, being higher than that in the West and Central regions. The satisfaction on the categories of drugs and prevention care service were 51.5% and 65.9% for the patients from the West regions, being higher than those from both East and Central re- gions （P 〈0. 0125）. （3） About the items that need to be further improved, the first three ones were the variety and quality of drugs （25.3%）, price of drugs （21.8%）, and medical skills （18.2%） in the East cities; essential facilities and equipment （28.2%）, price of drugs （21.8%）, and variety and quality of drugs （21.2%） in the Central cities; essential facilities and equipment （30. 8% ）, variety and quality of drugs （28.1%） and percentage and categories of imbursement of medical fees （

关 键 词：社区卫生服务 综合改革 患者 满意度 比较研究 

分 类 号：R197[医药卫生—卫生事业管理]