基于目标人群服务份额的乡镇卫生院服务竞争力研究

发布时间：2018-11-05 10:11

【摘要】：目的:观察2009年和2015年乡镇卫生院的竞争力变化,探讨其关键影响因素,为乡镇卫生院服务发展定位提供参考。方法:利用2010—2016"中国统计年鉴"、"中国卫生和计划生育统计年鉴"的数据,测算31个省份2009年和2015年乡镇卫生院服务份额水平及变化,用Pearson相关系数反映乡镇卫生院服务份额与相关因素的关系。结果:相较于2009年,2015年相关经济社会变量均大幅增长。2009年门诊份额与农村居民可支配收入正相关(r=0.39),与人均村医数量负相关(r=-0.39),2015年的相关无统计学意义;2009年住院服务份额与人均政府卫生投入和人均医院卫技人员数中度负相关(r=-0.58、-0.56),2015年则不再相关,与每千居民乡镇卫生院卫技人员数2009年不相关,2015年呈中度正相关。结论:新医改以来,乡镇卫生院门诊服务竞争力略有上升但住院竞争力明显下降,其服务竞争力和体系内上下游竞争者的关系以及与经济因素的关系均在减弱,转由人力资源和床位水平决定。要充分发挥乡镇卫生院的效能,关键是在界定服务功能基础上提升资源配置水。
[Abstract]:Objective: to observe the changes of the competitiveness of township health centers in 2009 and 2015 and to explore the key influencing factors so as to provide reference for the orientation of service development of township hospitals. Methods: using the data of China Statistical Yearbook 2010-2016 and China Health and Family Planning Statistical Yearbook, the service share level and changes of township health centers in 31 provinces in 2009 and 2015 were measured. The correlation coefficient of Pearson was used to reflect the relationship between service share and related factors in township health centers. Results: compared with 2009, the relative economic and social variables increased significantly in 2015. In 2009, the proportion of outpatient clinics was positively correlated with the disposable income of rural residents (r = 0.39), and negatively correlated with the number of village doctors per capita (r-0.39). There was no statistical significance for 2015; The share of hospital service in 2009 was negatively correlated with the health input per capita and the number of health workers per hospital (r: 0.58% -0.56), but not with the number of health workers per thousand residents in township health centers in 2015. There was a moderate positive correlation in 2015. Conclusion: since the new medical reform, the outpatient service competitiveness of township health centers has increased slightly, but the inpatient competitiveness has declined obviously, and the relationship between the service competitiveness and the upstream and downstream competitors in the system as well as the economic factors has been weakened. The transfer is determined by the level of human resources and beds. In order to give full play to the effectiveness of township health centers, the key is to improve the allocation of water resources on the basis of defining the service function.
【作者单位】：潍坊医学院公共卫生与管理学院;"健康山东"重大社会风险预测与治理协同创新中心;国民健康社会风险预警协同创新中心;潍坊医学院公共课教学部;
【基金】：国家自然科学基金项目(71173158)
【分类号】：R197.62

【相似文献】