| 引用本文：徐恒秋,代涛,陈瑶,等.安徽省基层卫生综合改革实施效果[J].中国卫生政策研究,2013,6(5):21-26 |
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| 安徽省基层卫生综合改革实施效果 |
| 投稿时间：2013-03-25 修订日期：2013-05-06 PDF全文浏览 HTML全文浏览 |
| 徐恒秋1, 代涛2, 陈瑶2, 夏北海2 |
| 1.安徽省卫生厅;2.中国医学科学院医学信息研究所/卫生政策与管理研究中心 |
| 摘要:目的：分析安徽省基层卫生综合改革的实施效果。方法：按照社会经济状况，选择安徽省三个城市6个区县共88家基层医疗卫生机构作为研究对象，收集2009—2011年的相关数据，分析基层卫生综合改革的实施效果。结果：2011年社区卫生服务中心和乡镇卫生院药占比分别降至23.97%和30.73%，基层卫生机构的补偿结构发生明显改变；大专以上学历卫生技术人员所占比例明显增加，人力资源数量和结构逐步改善；人员收入有所增长但满意度仍然不高。门急诊服务数量和效率提高，住院服务数量和效率有所降低，医疗费用得到控制，服务质量有所改善。结论：政府的强力推动是安徽省基层卫生综合改革迅速推进的重要保障。初步实现了建立公益性运行新机制的目标，但人力资源仍然不足，绩效考核与预期实现的激励效果仍存在差距。理顺政府与基层卫生机构之间的治理关系仍需继续努力；应完善招聘机制，合理提高医务人员收入，改进绩效考核方案，关注改革措施的综合作用，巩固已有成果。 |
| 关键词:基层卫生 综合改革 效果 |
| 基金项目:中澳卫生与艾滋病项目“医药卫生体制改革评价研究”；中央级公益性科研院所基本科研业务费“深化医药卫生体制改革监测与评价研究” |
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| Effect on primary healthcare comprehensive reform in Anhui province |
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| Abstract:Objective: In this paper, we discuss the effects of implementing primary healthcare comprehensive reform in Anhui province. Methods: Data was collected for the years 2009 to 2011 from 88 primary healthcare institutes in six districts and counties, and the effects of the primary healthcare reform were analyzed using an input process output method. Results: In 2011，the drug revenues had declined to 2397% and 30.73% respectively in community and township health centers. We found that the reimbursement structure of primary healthcare institutes has fundamentally changed. Human resources have been strengthened and the income of health care professionals has increased; however, satisfaction levels remain low. The service quantity and efficiency for outpatient service has improved, but that of the inpatient service has decreased. Quality and cost control for both outpatient and inpatient service has improved. Conclusion: Reforms in Anhui province have improved under the effective governance, but human resources are still not sufficient to cover the workload, and performance evaluation also needs to be improved. We suggest managers of primary healthcare institutes should be given greater power, and employment packages should be more flexible. We suggest gradually increasing the salaries of healthcare professionals and improving performance evaluation scheme. With regards to the behavior of stakeholders and effects of integrated policies, we suggest consolidating achievements of primary healthcare system reform. |
| Key words:Primary healthcare Comprehensive reform Effect |
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