四川省少数民族地区县乡村一体化实施效果评价研究  

Evaluation on the implementation effect of the County-Township-Village Integration in minority areas of Sichuan Province

作　　者：侯利莎 闫沛静 张雪莉 杜旭东[1] 甄丽丽[1] 程迪尔[3,4] 段占祺 潘杰[1] 

机构地区：[1]四川大学华西公共卫生学院(华西第四医院),四川成都610041 [2]四川省卫生和计划生育信息中心,四川成都610041 [3]北京大学中国卫生经济研究中心,北京100871 [4]中国药科大学,江苏南京211198

出　　处：《现代预防医学》2017年第2期264-267,共4页Modern Preventive Medicine

基　　金：国家自然科学基金"区域内医院间竞争对医疗费用和质量影响之空间测度与实证研究"(编号:71303165);四川省卫生和计划生育委员会"四川省民族地区县乡村一体化医疗模式效果研究"

摘　　要：目的探讨四川省少数民族地区县乡村一体化医疗模式的实施效果,为进一步的卫生决策提供参考。方法查阅相关文件和问卷调查搜集县乡村一体化实施前后县乡村三级医疗机构相关资料,采用倍差法对各级医疗机构卫生人员、设备设施和医疗服务等方面的变化情况进行评价。结果县乡村一体化实施初期,实施组在妇幼健康状况(新生儿死亡率下降了1.82‰,孕产妇死亡率下降了65.47/10万)、医疗卫生人员、设备设施、基本医疗卫生和基本公共卫生服务有所改善,但存在以下问题:民族地区医疗卫生技术人员相对缺乏(每千人口执业(助理)医师数和每千人口注册护士数均小于1)、基本医疗卫生服务地区间差异大、双向转诊存在挑战以及公共卫生基础薄弱和发展不均衡。结论县乡村一体化的实施一定程度上促进了县乡村三级医疗机构综合服务能力的提升,但三级医疗网络仍需进一步完善。Objective This work was to study the status and the implementation effect of the County-Township-Village Integration in minority areas of Sichuan Province, and to provide the references for health policy. Methods The effect of policy among three-level medical service network was evaluated by relevant literature review and questionnaire survey. Results Since the implementation of County-Township-Village Integration in 2013, medical institutions of different levels have improved in many aspects. However, many challenges still existed： short of health technical personnel in minority areas; sustainable development were very difficult for the two-way referral system （upward-referral being easier but downward referral being difficult）; the development of public health was weak and imbalanced. Conclusion The County-Township- Village Integration enhanced comprehensive service capabilities, but three-level medical service network still needs to be improved.

关 键 词：县乡村卫生服务一体化 倍差法 效果评价 少数民族地区 

分 类 号：R197[医药卫生—卫生事业管理]