武汉市社区卫生服务资源配置效果研究

发布时间：2018-05-14 15:23

本文选题：社区卫生服务 + 资源配置　；参考：《武汉大学》2017年硕士论文

【摘要】：医药卫生事业是关乎亿万人民的伟大事业,是解决我国民生问题的重要保障之一。近几年我国一直在探索医药卫生体制改革,改革至今处于深化的攻坚阶段,建设社区卫生服务机构有助于攻破医改屏障。同时在现代社会居民疾病谱发生重大变化的背景下,人们对于疾病预防越来越重视,社区卫生服务成为公共服务领域建设的热点。因此,社区卫生服务机构建设成为我国目前建设基层医疗卫生服务体系的重点,需要完善以社区卫生服务为基础的新型医疗卫生服务体系,加快建设城市社区卫生服务网络,使之承担起保障居民健康的"守门"职责。我国社区卫生服务立足于初级卫生保健,以社区居民健康为中心,致力于提供基础性、预防性、综合性的全科医疗服务,有利于我国病有所医目标的实现。在国家的倡导、支持下,近年来我国社区卫生服务事业蓬勃发展,服务机构数量大幅度增加,卫生医疗资源得到极大的扩充。武汉市政府立足于广大市民,在认真、深刻贯彻新医改要求的前提下,对于建设社区卫生服务机构非常重视,先后在2010年和2013年发布相关文件在全市范围内督促建设、完善社区卫生服务机构,明确要求打造15分钟社区卫生服务圈,力争取得初步建成居民社区首诊制,切实减轻居民医疗负担的效果。在此基础上本文考察武汉市的社区卫生服务机构按照文件标准进行建设后的状况,以资源配置为维度,对其是否取得满意的效果进行分析。研究结果表明:目前的建设没有取得预期的效果,社区首诊制尚未实现,就诊人数没有显著增加,居民诊治负担没有得到明显减轻。但起到了一定的改善作用,比如人力资源方面:切实扩充居民可获得的医护资源、促进管理作用的发挥,管理层有所壮大;物力资源方面:卫生服务可及性有所提高、医疗技术力量进一步增强;财力资源方面:政府财政投入重视度提高。但由于建设时只重视数量的扩充,忽视对质量的追求,另外,缺乏监管,落实不到位。存在一些不足,具体表现为:人力资源方面,卫生技术人员结构不合理现象没有改善(包括学历、职称、编制结构);物力资源方面,机构区域布局存在不公平性、医疗服务资源利用率和卫生设备工作效率未达到标准;财力资源方面,落实不理想以及补贴、补偿标准偏低,社区卫生机构经营恶劣。针对不足,结合武汉市社区卫生服务建设实际情况,提出相应的改良建议和针对性的实施策略,以期优化社区卫生服务资源配置,更好地提高武汉市社区卫生服务机构的服务水平,实现社区首诊制的初步形成,切实减轻居民医疗负担。
[Abstract]:Medical and health care is a great undertaking related to hundreds of millions of people and an important guarantee to solve the livelihood problems of our country. In recent years, China has been exploring the reform of the medical and health system. The reform is still in the stage of deepening, and the construction of community health service institutions will help to break through the barrier of medical reform. At the same time, people pay more and more attention to disease prevention under the background of great changes of disease spectrum in modern society. Community health service has become a hot spot in the field of public service. Therefore, the construction of community health service institutions has become the focus of our country's current construction of primary medical and health service system. It is necessary to improve the new medical and health service system based on community health service, and speed up the construction of urban community health service network. To assume the responsibility of safeguarding the health of the residents, "gatekeepers". The community health service in our country is based on primary health care, taking the health of community residents as the center, and devoting to providing basic, preventive and comprehensive general medical service, which is conducive to the realization of the goal of treating diseases in our country. With the support of the government, the community health service in China has developed rapidly in recent years, the number of service institutions has increased greatly, and the health and medical resources have been greatly expanded. Based on the general public, the Wuhan Municipal Government, under the premise of conscientiously and profoundly implementing the requirements of the new medical reform, attaches great importance to the construction of community health service institutions, and successively issues relevant documents in 2010 and 2013 to urge the construction of the project throughout the city. Improve the community health service institutions, explicitly request to create a 15-minute community health service circle, strive to achieve the initial establishment of community first visit system, effectively reduce the burden of medical care for residents effect. On this basis, this paper investigates the situation of the community health service institutions in Wuhan after construction according to the document standard, and analyzes whether the community health service institutions in Wuhan have achieved satisfactory results from the perspective of resource allocation. The results show that the present construction has not achieved the expected effect, the community first visit system has not been realized, the number of patients has not increased significantly, and the burden of diagnosis and treatment has not been significantly reduced. But it has played a certain role in improving, for example, in terms of human resources: to effectively expand the health care resources available to residents, to promote the role of management, the management has grown; material resources: health services have increased accessibility, Medical technical strength further enhanced; financial resources: government financial investment increased attention. But because the construction only pays attention to the quantity expansion, neglects the pursue to the quality, in addition, lacks the supervision, the implementation is not in place. There are some shortcomings, such as: human resources, unreasonable structure of health technical personnel (including academic qualifications, professional titles, compilation structure), unfairness in the regional distribution of institutions in the area of material resources, The utilization rate of medical service resources and the working efficiency of sanitary equipment did not reach the standard; in the aspect of financial resources, the implementation was not ideal and subsidies, the compensation standard was low, and the operation of community health institutions was poor. According to the actual situation of community health service construction in Wuhan, the paper puts forward corresponding improvement suggestions and targeted implementation strategies in order to optimize the allocation of community health service resources. To improve the service level of community health service institutions in Wuhan, to realize the initial formation of community first visit system, and to lighten the burden of residents' medical treatment.
【学位授予单位】：武汉大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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