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作 者:梁金刚 Liang Jin’gang(University of Chinese Academy of Social Sciences,Beijing,P.R.China)
出 处:《中国卫生事业管理》2025年第1期57-58,89,共3页Chinese Health Service Management
基 金:北京市社会科学基金青年项目“基于接诉即办的北京社会风险识别与防控机制研究”(22SRC019)。
摘 要:目的:探究新医改以来“强基层”政策效果态势,提升基层医疗卫生服务能力。方法:根据2010~2021年中国卫生健康统计年鉴数据,选取诊疗人次、收支结余状况、人员状况、机构状况四个指标,按照时间序列采取描述性统计方法对“强基层”效果进行分析。结果:发现诊疗人次绝对量呈“N”型波动,相对占比下降趋势明显;收支规模增大,但收支结余率保持低位;执业(助理)医师总量增长,但农村卫生人员流失;基层医疗卫生机构总量呈不断上涨趋势,但村卫生数量呈下降趋势。结论:基层医疗卫生机构成效受限的瓶颈主要归因于工作力量不充实、激励机制不健全、技术手段不充分、协同机制不顺畅。建议创新服务、完善功能,筑牢医疗卫生服务“网底”;确保基层医疗卫生机构人员、药品、检验检查设备等资源供给;充分发挥大数据、互联网、人工智能等技术的嵌入使用;完善基层医疗卫生机构和人员激励机制。Objective To explore the effect of"strong grassroots"policy since the new medical reform and improve the ability of grassroots medical and health services.Methods Based on the data of China Health Statistical Yearbook from 2010 to 2021,four indicators of diagnosis and treatment number,balance of income and expenditure,personnel status and institutional status were selected to conduct descriptive statistics and comparative analysis of the effect of"strong grassroots".Results The absolute number of medical visits showed an"N"type fluctuation,and the relative proportion had an obvious downward trend.The scale of revenue and expenditure increased,but the balance ratio of revenue and expenditure remained low.The total number of practicing(assistant)physicians increased,but rural health personnel lost.The total number of primary health institutions was increasing,but the number of village health institutions was decreasing.Conclusion The bottleneck of the limited effectiveness of primary health institutions is mainly attributed to the insufficient work force,the imperfect incentive mechanism,the insufficient technical means,and the unsmooth coordination mechanism.It is suggested to innovate services,perfect functions,and strengthen the"bottom of the network"of health services,ensure the supply of resources such as staff,drugs,inspection and inspection equipment for primary health institutions,give full play to the embedding and use of big data,internet,artificial intelligence and other technologies,improve the incentive mechanism of health institutions and personnel.
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