An empirical study on performance evaluation index system of basic public health services in Chongqing
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摘要:
目的 对2017年度全市40个区(县)的国家基本公共卫生服务项目实施评估,使重庆市国家公共卫生服务项目实施与管理更加规范,并讨论绩效考核指标体系的优缺点。 方法 将重庆市40个区(县)根据区域经济发展水平分为主城区、近郊区、渝东北和渝东南,共4个区域,应用更适合重庆实际情况的基本公共卫生服务绩效考核指标体系(即组织管理、资金管理、项目执行、项目效果、家庭医生签约服务,共5个1级指标)对全市2017年度的基本公共卫生服务项目于2017年12月份进行现场考核,不同区域之间的考核结果进行差异性分析。 结果 考核指标除组织管理、资金管理外,总分、项目执行、项目效果和家庭医生签约服务在4个不同经济区域比较差异有统计学意义(均P < 0.05),主城区各项指标得分(组织管理6.23分、资金管理4.76分、项目执行69.35分、项目效果8.99分、家庭医生签约服务2.07分)都处于全市前列,渝东南经济发展区各项得分(组织管理6.07分、资金管理4.48分、项目执行60.94分、项目效果8.42分、家庭医生签约服务2.04分)处于末位;项目效果考核指标在各区县得分普遍偏低。 结论 通过考核评价,重庆市基本公共卫生服务区域间差距明显,基本公共卫生服务均等化仍需提高;重庆市基本公共卫生服务质量不高,效果不佳;新指标体系弥补了对重庆市基本公共卫生服务绩效考核面不全、指标简单不够量化等不足。 Abstract:Objective To evaluate national basic public health service projects in 40 districts (counties) of Chongqing in 2017, so making the implementation and management of national public health service projects in Chongqing more standardized, and discuss the advantages and disadvantages of the performance evaluation index system. Methods According to the level of regional economic development, 40 districts (counties) in Chongqing were divided into four regions: main urban area, suburban area, Northeast Chongqing and Southeast Chongqing. The performance evaluation index system of basic public health services (organization management, fund management, project implementation, project effect and family doctor signing service, a total of five level-1 indicators) more suitable for the actual situation of Chongqing was applied to on site evaluate the basic public health service project in 2017 in December 2017. The difference of the performance evaluation results among different regions was analyzed. Results Except organizational management and capital management, the other indicators were significant differences in the four different economic regions, which were total score, project execution, project effect and family doctor contract service (all P < 0.05). The scores of all indicators (organizational management 6.23 points, capital management 4.76 points, project execution 69.35 points, project effect 8.99 points and family doctor contract service 2.07 points) in the main urban area were in the forefront of Chongqing. The scores (organizational management 6.07 points, capital management 4.48 points, project execution 60.94 points, project effect 8.42 points and family doctor contract service 2.04 points) of the economic development area in southeast Chongqing were in the last place. The scores on project effect were generally low in each district and county. Conclusion According to the evaluation, there is a clear regional gap in basic public health services in Chongqing, and the equalization of basic public health services still needs to be improved. The quality of basic public health services is not high and the effect is not so good. The new index system makes up for the deficiencies of the performance evaluation of basic public health services in Chongqing, simple and quantitative indicators, etc. -
Key words:
- Basic public health services /
- Performance evaluation /
- Index system /
- Empirical study
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表 1 不同经济发展区域绩效考核评估得分(x±s,分)
不同区域 个数 组织管理 资金管理 项目执行 项目效果 家庭医生签约服务 总分 主城区 10 6.23±0.11 4.76±0.43 69.35±4.28a 8.99±0.73 2.07±0.12b 91.40±4.76a 近郊区 13 6.06±0.27 4.83±0.10 67.28±2.81a 9.28±0.61a 1.95±0.18b 89.35±2.92a 渝东北 11 6.07±0.20 4.70±0.36 66.54±2.93a 8.70±0.54 1.54±0.30 87.55±3.63a 渝东南 6 6.07±0.30 4.48±0.49 60.94±9.00 8.42±0.40 2.04±0.24b 81.95±9.75 F值 1.320 1.490 4.380 3.040 12.810 4.720 P值 0.283 0.233 0.010 0.042 < 0.001 0.007 注:与渝东南相比,aP < 0.05;与渝东北相比,bP < 0.05。 表 2 40个区县绩效考核评估得分(分)
区域区县 组织管理 资金管理 项目执行 项目效果 家庭医生
签约服务总分 主城区 大渡口区 6.313 4.898 72.169 9.669 2.048 95.097 北碚区 6.278 4.898 72.102 9.538 2.125 94.941 渝中区 5.955 4.898 71.684 9.175 1.851 93.563 九龙坡区 6.242 4.865 72.230 7.674 2.200 93.211 巴南区 6.250 4.898 71.571 8.830 1.908 93.457 南岸区 6.255 4.898 70.753 9.306 1.998 93.210 沙坪坝区 6.302 4.931 70.034 9.752 2.110 93.129 渝北区 6.101 4.898 67.303 7.760 2.219 88.281 江北区 6.297 4.898 67.283 9.255 2.154 89.887 两江新区 6.312 3.541 58.390 8.953 2.056 79.252 近郊区 合川区 6.034 4.818 71.921 10.444 2.112 95.329 涪陵区 6.114 4.898 68.936 9.756 1.598 91.302 江津区 6.153 4.898 71.519 8.480 2.085 93.135 荣昌区 6.031 4.898 69.660 8.875 1.856 91.320 南川区 6.233 4.898 68.660 9.084 1.956 90.831 潼南区 5.976 4.871 65.152 9.534 1.675 87.208 永川区 5.932 4.731 68.057 8.184 1.760 88.664 綦江区 6.176 4.831 64.136 9.618 2.089 86.850 万盛经济技术开发区 6.262 4.548 67.945 9.300 2.011 90.066 璧山区 5.254 4.858 65.716 9.613 2.112 87.553 大足区 6.236 4.865 63.657 8.609 2.128 85.495 长寿区 6.273 4.815 64.731 9.492 1.934 87.245 铜梁区 6.146 4.831 64.588 8.974 2.003 86.542 渝东北 忠县 6.070 4.898 70.058 9.116 1.867 92.009 丰都县 6.291 3.849 70.715 8.612 1.785 91.252 开州 5.694 4.898 66.779 9.069 1.715 88.155 垫江县 6.168 4.548 67.827 9.296 1.641 89.480 城口县 6.240 4.845 64.271 8.490 1.355 85.201 梁平区 6.294 4.891 67.319 8.955 1.863 89.322 巫山县 6.062 4.898 66.244 8.491 1.655 87.350 巫溪县 5.758 4.192 62.418 7.934 0.961 81.263 奉节县 6.125 4.871 61.898 7.578 1.372 81.844 万州区 6.090 4.898 69.326 9.028 1.616 90.958 云阳县 5.999 4.898 65.030 9.115 1.128 86.170 渝东南 黔江区 6.247 4.898 69.112 8.232 2.159 90.648 武隆区 5.668 4.898 68.858 8.521 2.200 90.145 石柱县 6.284 4.865 66.310 8.527 1.610 87.596 秀山县 6.309 3.830 56.730 8.761 2.170 77.800 彭水县 6.215 4.425 58.663 8.778 2.200 80.281 酉阳县 5.711 3.937 45.979 7.713 1.872 65.212 -
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