成都市新津县公益性医疗卫生服务体系改革绩效评估系列之一:新津县基层医疗卫生服务体系改革总体绩效  

Performance Evaluation of Primary Healthcare System Reform in Xinjin County, Chengdu City:Ⅰ.Total Performance

作　　者：王莉[1] 沈建通[1] 李幼平[1] 师成虎[1] 李筱[1] 王应强[1] 李萃萃[1] 杨宗霞[1] 

机构地区：[1]四川大学华西医院中国循证医学中心,成都610041

出　　处：《中国循证医学杂志》2014年第1期2-6,共5页Chinese Journal of Evidence-based Medicine

基　　金：成都市卫生局资助项目"新津县公益性医疗卫生服务体系改革绩效评估"(编号:H1106077)

摘　　要：目的评估新津县基层医疗卫生改革现状,为完善和推行成都市公益性医疗卫生服务体系提供基线数据。方法定量描述和比较新津县医疗卫生服务体系和人群健康。结果①新津县完成11家乡镇公立卫生院(100%)、89家村卫生站(66.42%)标准化建设,60家村卫生站一体化管理,乡院开展基本医疗服务417项,村卫生站76项。②2010全县医疗机构门诊人次同比增长24.2%,住院人次同比增长46.3%,门诊次均费用同比下降21.5%,住院费用同比下降18.6%。③2010年居民电子健康档案建档率98.2%,孕产妇系统管理率96.3%,免疫规划五苗全程接种率98.8%,重症精神疾病患者规范管理率100%,高血压、糖尿病管理率约78%,免费健康体检率28.8%。④全县基层医疗机构基本药物使用品种比达96.7%,销售金额比达97.8%,药品管理成本由8.5%下降到4.2%,药品周转率提高50%。⑤新津县人均期望寿命77.97岁,婴幼儿死亡率6.82‰,孕产妇死亡数连续8年为0。⑥构建了覆盖县、乡、村三级医疗卫生服务的区域卫生信息网络体系。结论①新津县医疗卫生服务改革促进了基层卫生机构建设,提高了医疗、公共卫生服务利用及基本药物的使用;②新津县人均期望寿命、孕产妇死亡率、婴幼儿死亡率优于四川省和全国平均水平,接近世界高收入国家水平;③新津县作为成都市医疗卫生改革试点具有代表性,以区域医疗卫生信息平台为依托,推行医疗卫生改革和管理具有较高示范价值。ObjectiveTo evaluate the current status of primary healthcare system reform in Xinjin county, in order to provide baseline data for improving the healthcare service system and population health in Chengdu. MethodsPrimary health care services and population health in Xinjin county were quantitatively described and compared. Resultsa） Eleven township hospitals （100%） and 89 village clinics （66.42%） were upgraded according to the national standards. The management of 60 village clinics were integrated with township hospitals. And 417 and 76 essential healthcare services were provided by township hospitals and village clinics, respectively. b） In 2010, the number of outpatients and inpatients in Xinjin county were increased by 24.2% and 46.3% respectively compared to those of 2009, while the costs per outpatient visit and inpatient discharge were reduced by 21.5% and 18.6% respectively. c） In 2010, health records of 98.2% of population in Xinjin county have been established; 96.3% of pregnant women were managed systematically; 98.8% of children immunization programs were implemented; 100% patients with severe mental disorders and about 78% with hypertension and diabetes were in follow-up and treatment; and 28.8% of total population got the free physical exams in 2010. d） The essential medicine accounted for 96.7% of total types of medicines and 97.8% of total expenditure of medicines in primarily healthcare institutions in Xinjin. The cost of medicine management was reduced from 8.5% to 4.2% while the medicine turnover rate was increased by 50%. e） Average life expectancy in Xinjin county was 77.97 years, infant mortality rate was 6.82‰ in 2010; and there was no maternal death in recent 8 years. f） The regional healthcare information system was established covering three-tier rural health care network spanning the county, township and village. Conclusiona） The primary healthcare system reform in Xinjin county improves the infrastructure of primary care system, the utilization of essential medi

关 键 词：基层医疗卫生服务体系 卫生改革 新津县 绩效评估 调查 

分 类 号：R197.1[医药卫生—卫生事业管理]