北京远郊区县社区卫生服务机构人力配置标准研究  

The Allocation Standard of Manpower in Community Health Service Settings in Beijing Outer Suburb Area

作　　者：吴妮娜[1] 吕兆丰[1] 王晓燕[1] 韩优莉[1] 黄昊[1] 李珑[1] 

机构地区：[1]首都医科大学卫生管理与教育学院,北京市100069

出　　处：《中国全科医学》2015年第22期2637-2640,2647,共5页Chinese General Practice

基　　金：国家软科学项目(2010GXS5D179);教育部人文社会科学面上项目(10YJAZH055);北京市哲学社会科学重大项目(11ZDA05);北京市属高等学校教学创新人才--教学名师项目(PHR201106207);北京市哲学社会科学青年项目(10Bd SH089)

摘　　要：目的：建立基于人群对社区卫生服务实际利用状况的卫生人力需求模型，为制定基层卫生人力配置标准提供参考。方法2012年4—6月，通过对北京市4个远郊区县（分别来自深山区、半山区、平原和城乡结合部）的社区卫生服务机构和3133名居民的现场调查，分析基层卫生人力资源需求和配置状况。采用卫生人力需求法测算社区卫技人员需求量。结果目前居民首选社区卫生服务机构就诊的比例仅为31.20％，社区卫生服务机构的卫技人员配置总量为1293人（1.51人／千人），按30％社区首诊的需求测算仅需卫技人员1.49人／千人；但是，若实现60％～90％的社区首诊，则需增加卫技人员2～3人／千人。各岗位人员中，护理人员和防保人员配置的缺口较大。结论目前各区县的每千人口卫技人员量基本能够满足甚至超过居民的需求，但随着健康守门人职责的落实，平原、城乡结合部和半山区还需增加卫生人力，达到每千服务人口配置2～3名卫技人员，深山区需要根据服务半径、可及性和服务人口的状况配置最基本的医疗服务团队，满足基本卫生服务需求。Objective To establish a health manpower demand model based on the actual utilization of community health services and to provide references for formulating the allocation standard of health manpower at grass -root level.Methods From April to June in 2012, we conducted field investigation with 3 133 residents in the community health service settings of 4 areas in Beijing outer suburb （ including mountainous area , semi-mountainous area , plain area and rural-urban continuum ） . The health manpower demand and allocation status at grass -root level were analyzed , and the demand of community health workers was calculated by the health manpower demand method .Results The proportion of residents who chose community health service settings as the place for first contact diagnosis was only 31.20%, The total number of health workers in community health service settings was 1 293, with 1.51 health workers per thousand residents .If we assumed 30% of residents chose community health service settings to receive first contact diagnosis , 1.49 health workers for per thousand residents were enough , while if the proportion increased to 60% to 90%, 2 to 3 health workers per thousand residents were needed .There was a serious lack of nursing staff and prevention staff.Gonclusion Currently, health workers allocated for per thousand residents in Beijing outer suburb can basically satisfy or even exceed residents′demand.However , with the better fulfillment of the responsibility as the health gatekeeper , community health service settings in plain area , rural-urban continuum and semi -mountainous area should allocate 2 to 3 health workers per thousand residents .In mountainous area , basic health service team should be allocated according to service radium , accessibility and service population , in order to satisfy the basic demand for health service .

关 键 词：社区卫生服务机构 卫生人力 资源分配 标准 

分 类 号：R197[医药卫生—卫生事业管理]