镇村卫生一体化管理下京郊村卫生室服务现状及发展对策探究

陈静静; 王海利; 彭迎春

doi:10.16766/j.cnki.issn.1674-4152.003383

镇村卫生一体化管理下京郊村卫生室服务现状及发展对策探究

doi: 10.16766/j.cnki.issn.1674-4152.003383

1.
北京市怀柔区琉璃庙镇社区卫生服务中心，北京 101499
2.
首都医科大学医学人文学院，北京 100069

基金项目:

北京市社会科学基金项目 22SRB008

北京市怀柔区卫生健康委员会科研项目 2021-B-001

北京市怀柔区卫生健康委员会科研项目 2022-C-002

北京市“十百千社区卫生人才”专题支持项目 2023

详细信息

通讯作者:
彭迎春，E-mail：pycjql@ccmu.edu.cn

中图分类号: R197.61
计量
- 文章访问数: 33
- HTML全文浏览量: 12
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-12
- 网络出版日期: 2024-03-27

Exploration on the current situation and development countermeasures of health room services in Beijing suburb villages under the integrated management of rural health

1.
Liu Li Miao Town Community Health Service Center, Huairou District, Beijing 101499, China

摘要

摘要: 目的了解京郊村卫生室服务现状，从人员队伍、服务及管理角度分析在乡村一体化管理中存在的问题并提出解决建议。方法对北京市怀柔区171名在岗乡村医生、433名常驻居民以及26名社区卫生服务中心管理者进行调查与访谈，了解村卫生室服务提供及绩效考核情况、居民的卫生服务需求及其对服务利用情况等；同时，从镇村两级医疗机构信息系统和数据上报系统调取村卫生室和社区卫生服务中心服务数量数据，了解村卫生室服务开展情况。结果在岗乡村医生中，155名(90.6%)持有乡村医生执业证书或者取得了乡村全科执业助理医师资格，170名(99.4%)乡村医生从事或从事过务农、养殖等非医疗工作；村卫生室月总门诊量占社区卫生服务中心门诊量的4.21%(967人次/年)，其中72.49%(701人次/年)为单纯测量血压；诊疗服务是居民需求率最高的服务项目，乡村医生对于绩效考核关注不够，绩效考核过程不规范，结果激励作用不明显。结论村卫生室的机构职责界定不清晰、服务内容标准不统一、不规范，影响乡村卫生服务一体化推进；同时，乡镇社区卫生服务中心在乡村卫生服务一体化管理中的职能有待明确。建议明确村卫生室的服务范围和服务标准实现服务的同质化，优化村卫生室的服务方式和管理模式，实现药品、财务的一体化管理，加快乡村医生培养，推进服务人员和绩效考核的一体化管理。
- 一体化管理 /
- 村卫生室 /
- 医疗卫生服务
Abstract: Objective To understand the current situation of health room services in suburban villages in Beijing, and analyze the problems in integrated rural management from the perspectives of personnel team, service, and management, and propose solutions. Methods A survey and interview were conducted on 171 on-the-job rural doctors, 433 permanent residents, and 26 community health service center managers in Huairou District, Beijing, to understand the situation of service provision and performance assessment of village clinics, residents' demand for health services and their utilization of services, etc., through the information system and data reporting system of medical institutions at the village and village levels, the data such as the number of services provided by village clinics and community health service centers were collected to understand the situation of services provided by village clinics. Results Among on-the-job rural doctors, 155 (90.6%) hold a rural doctor practice certificate or have obtained the qualification of a rural general practitioner assistant physician, and 170 (99.4%) of rural doctors have engaged in or engaged in non-medical work such as farming and aquaculture. The total monthly outpatient volume of village clinics accounts for 4.21% (967 cases/year) of the total outpatient volume of community health service centers, of which 72.49% (701 cases/year) were simply measuring blood pressure. Diagnosis and treatment services were the service items with the highest demand rate among residents. Rural doctors did not pay enough attention to performance evaluation, the performance evaluation process was not standardized, and the incentive effect of the results was not obvious. Conclusion The unclear institutional responsibilities, inconsistent and non-standard service content standards of village clinics have affected the integration of rural health services. At the same time, the functions of township community health service centers in the integrated management of rural health room services need to be clarified. It is recommended to clarify the service scope and standards of village clinics, achieve homogenization of services, optimize the service methods and management models of village clinics, achieve integrated management of drugs and finance, accelerate the training of rural doctors, and promote integrated management of personnel and performance evaluation.
- Integrated management /
- Village health room /
- Health services

HTML全文

表 1 433名被调查的居民患慢性病情况

Table 1. The prevalence of chronic diseases among 433 surveyed residents

慢性病种类	人次	顺位
高血压	148	1
糖尿病	38	2
冠心病	18	3
脑卒中	3	6
慢性阻塞性肺疾病	1	7
骨关节病	5	5
其他重大慢性疾病	9	4

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表 2 433名被调查居民在村卫生室的年就诊频率

Table 2. Annual visit frequency of 433 surveyed residents in village clinics within the year

年就诊频率	人数	构成比(%)
1次	41	17.37
2~4次	91	38.56
4~12次	59	25.00
12次以上	45	19.07
合计	236	100.00

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表 3 433名被调查的居民对村卫生室的服务需求情况

Table 3. Service demand for village clinics among 433 surveyed residents

服务需求	人次	顺位
健康咨询服务	122	2
看病就诊	218	1
健康管理	37	3
转诊去大医院	20	5
组织体检服务	33	4
其他	2	6

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