精准帮扶政策对新疆农村地区基层医疗机构的发展影响及机构服务供给能力现状调查  

Investigation and Analysis on the Impact of Precision Help Policy on the Development of Primary Medical Institutions in Rural Areas of Xinjiang and the Current Situation of Service Supply Capacity

作　　者：卡迪尔亚·那斯尔 古丽巴哈尔·卡德尔[1] 郭志龙 麦尔当·艾力木[3] 王磊 木开达斯·塔西 KADIERYA Nasier;GULIBAHAER Kadeer;GUO Zhilong(School of Public Health,Xinjiang Medical University,Urumqi,830011,China;不详)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆维吾尔自治区卫生健康委员会,新疆乌鲁木齐830001 [3]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001 [4]伊犁州卫生局,新疆伊犁835000 [5]喀什地区卫校,新疆喀什844000

出　　处：《中国社会医学杂志》2021年第6期684-688,共5页Chinese Journal of Social Medicine

基　　金：国家社会科学基金项目(17 BRK030)。

摘　　要：目的探讨精准帮扶政策对新疆农村地区基层医疗机构的发展和服务供给能力产生的影响,并为实施过程中的不足提供政策性建议。方法①采用定性研究方法,将方便抽样与目的抽样相结合,抽取新疆南、北、东疆农村地区共106个基层医疗机构的396名医务人员进行半结构式访谈,根据扎根理论的研究方法采用NVivo 11.0质性分析软件,按照三级编码原则对访谈资料进行编码、归纳、提炼,最后形成9个理论范畴,并用帕累托图筛选主要因素、次要因素和一般因素;②采用文献分析法提取《2015-2018年新疆卫生统计年鉴》数据进行统计描述。结果定性研究结果显示,精准帮扶政策对农村地区基层医疗机构发展的影响归类为机构规模、管理制度、人才建设、经济效益、社会效益、人员培训、医疗服务、硬件设施、政府补助9个维度,其中硬件设施、社会效益、人员培训为促进医疗机构发展的关键因素,机构规模是重要因素,管理制度、人才建设、经济效益、社会效益、医疗服务、政府补助是一般因素。文献分析结果显示,2015-2018年新疆农村基层医疗机构的床位数、卫生技术人员数、政府卫生支出比例、门诊服务量呈正增长趋势,卫生管理人员、住院服务量呈负增长趋势,病床使用率逐年下降。结论精准帮扶政策对基层医疗机构的发展呈现出促进作用,但还未达到理想状态,需要培养优秀管理人员来促进效益,平衡卫生技术人员与床位数的比例,提高住院服务供给能力,持续引进中高级住院医师,提高住院医疗服务水平,改善机构环境卫生,以此为医疗机构的长远发展奠定基础。Objective To explore the influence of precision help policy on the development and service supply of primary medical institutions in rural areas of Xinjiang,and provide policy recommendations.Methods Combining convenient sampling with target sampling,396 medical personnel from 106 primary medical institutions in rural areas of southern,northern and eastern Xinjiang were selected and investigated with semi-structured interviews.According to the research method of rooted theory,NVivo 11.0 qualitative analysis software was used to encode,summarize,refine and finally formed nine theoretical categories of interview data according to the principle of three-level co-ding.The main factors,secondary factors and general factors were screened by Pareto chart.The data of“Xinjiang Health Statistics Yearbook 2015-2018”were extracted by literature analysis method.Results The impact of the"precision help"policy on the development and service supply of primary medical institutions in rural areas was classified into nine dimensions:institutional scale,management system,talent construction,economic and social benefits,personnel training,medical services,hardware facilities,and government subsidies.Among them,hardware facilities,social bene-fits and personnel training were the key factors to promote the development of medical institutions.Institutional size was an important factor.Management system,talent building,economic and social benefits,medical services,government subsidies were general factor.Literature analysis showed that the number of beds,the number of health technicians,the proportion of government health expenditure and the number of outpatient service in rural primary medical institutions in Xinjiang in 2015-2018 showed a positive growth trend,while there was a ne-gative trend in the number of health managers,hospital services,and the utilization rate of hospital beds decreased year by year.Conclusion The policy of"precision help"has promoted the development of primary medical institutions,but it has not reached th

关 键 词：基层医疗机构 精准帮扶政策 影响因素 服务供给能力 

分 类 号：R197[医药卫生—卫生事业管理]