政府购买绩效合同管理模式对农村公共卫生服务的影响  

Impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas

作　　者：张萌[1] 王小合[1] 吴建[2] 赵要军[3] 谢双保 张亮[5] 

机构地区：[1]杭州师范大学医学院卫生事业管理系,杭州310036 [2]郑州大学公共卫生学院 [3]河南省肿瘤医院 [4]河南省卫生厅 [5]华中科技大学同济医学院医药卫生管理学院

出　　处：《中华医院管理杂志》2014年第11期826-830,共5页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金青年基金资助项目（71403075）;教育部人文社科研究青年基金项目（09YJC630054）;世界银行贷款/英国赠款中国农村卫生发展项目河南省咨询课题（HN-ZX-2010-5A-4）

摘　　要：目的 分析政府购买绩效合同管理模式对农村公共卫生服务公平性和效率的影响.方法 采用随机对照法、机构调查法和公共卫生服务对象问卷调查法,调查乡镇居民对国家基本公共卫生服务利用情况及公平性和效率.结果 试点县服务对象对于居民健康档案管理、儿童健康管理、高血压和2型糖尿病患者健康管理服务的利用是较高质量的绝对公平,Gini系数值均＜0.2,且CI值接近于0.试点县乡镇的公共卫生服务提供总体、技术和规模有效性均优于非试点县的乡镇.结论 政府购买绩效合同管理模式有利于改善农村公共卫生服务的公平性,且提高服务效率.Objective To analyze the impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas.Methods Randomized controlled method,agency investigation and questionnaire survey on public health services recipients were used.Results The utilization of residents health records management services,child health management services,health care management of patients with hypertension and type 2 diabetes in pilot counties was higher quality absolutely fair.Gini＜0.2,CI≈0.The overall effectiveness,technical validity and effectiveness of scale of the townships in pilot counties were better than that in non-pilot county.Conclusion This management mode helps to improve the equity of public health services and service efficiency.

关 键 词：政府购买 绩效合同 农村 公共卫生服务 

分 类 号：R197.1[医药卫生—卫生事业管理]