四川省乡镇卫生院基本公共卫生服务工作量和人力需求研究  

Study of the Workload and Human Resources Demand of Basic Public Health Services in Township Hospitals of Sichuan Province

作　　者：朱梦蓉[1] 杨先碧 杨珉[1] ZHU Meng-rong;YANG Xian-bi;YANG Min(Department of Health Policy and Management,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Integrated Care Management Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院卫生政策与管理学系,成都610041 [2]四川大学华西医院患者全程管理中心,成都610041

出　　处：《四川大学学报（医学版）》2021年第5期783-788,共6页Journal of Sichuan University(Medical Sciences)

基　　金：中华医学基金会(No.CMB Grant 16-252,2016-2019)资助。

摘　　要：目的了解四川省乡镇卫生院基本公共卫生服务(简称基公服务)工作量情况,为完善基公服务人力资源配置,提升服务质量提供依据。方法采用单位时间服务量的实耗工时回顾性调查法,现场调查收集一个经济发达地区和一个经济中等发达地区的7个乡镇卫生院的2018年基公服务数量和人员单位服务工作时间,根据实耗工时测算所需人力。结果各项基公服务基本单位耗时变异较大,前4位耗时最多且两地区一致的服务依次是健康教育、卫生监督协管、0~6岁儿童管理和孕产妇管理。经济中等发达地区机构人员除在儿童预防接种建证、高血压患者管理和卫生监督协管任务上人均服务量大于经济发达地区外,其他各项服务量均低于后者。全职人员在两地区均存在短缺。结论基公服务量在不同经济水平地区间存在差异,人力资源短缺可能与服务质量的降低和数量减少相关。综合探索人才引入留用政策、强化基层业务培训、优化信息化手段将有助于提升基层服务能力和质量。Objective To understand the basic public health service(BPHS)tasks and workload of the township hospitals in Sichuan Province and to provide empirical evidence for improving the allocation of human resources(HR)and the quality of BPHS in township hospitals.Methods Retrospective survey was conducted to collect information regarding the actual working hours per unit time of service of BPHS.Information on the service volume and unit service time of BPHS tasks for 2018 was collected in 7 township hospitals in an economically developed area and an area of moderate economic development.Estimated HR required to cover the BPHS tasks was calculated based on the survey data of actual work time.Results The time required for the basic units of various BPHS tasks varied greatly.The top four most time-consuming services showing consistent results in the the two regions were health education,health supervision and coordination,management of children aged 0-6 and maternal care management.Institutions in the area of moderate economic development reported higher per capita service volume in the registration of children for vaccination,management of hypertension,and health supervision and coordination than those in the economically developed area,but lower service volume for other services.There is a shortage of full-time staffs in both areas.Conclusion Differences in the service volume of BPHS exist in regions of different levels of economic development.The shortage in HR could be related to the lower quality and volume of the service.Comprehensive exploration of policies to recruit and retain competent personnel,the strengthening of grassroots professional training,and optimization of information technology will help improve the competence and quality of grassroots services.

关 键 词：基本公共卫生服务 乡镇卫生院 工作量 人力需求 

分 类 号：R197.62[医药卫生—卫生事业管理]