摘要
目的了解成都市基层卫生人力资源绩效基线现状,为我国提高基层卫生人力资源绩效及统筹城乡卫生改革提供基线证据与政策建议。方法同本系列研究之二。结果①成都市三圈7个乡院/中心近5年诊疗人次均稳中有升,除最偏远两个乡院(人和、白鹿)外,均高于全国乡院平均水平。②在全球、全国、重庆还不能得到确切数据的情况下,7个乡院/中心的"六位一体"工作能得到较详实的数据,且普遍高于全球、全国平均绩效水平,但一圈到三圈呈递减趋势。③成都市乡镇/社区患者对乡院/中心"六位一体"工作满意、很满意率达65%～80%,但卫生人员的工作满意、很满意率仅9%～46%,且一圈到三圈呈递减趋势。结论①成都市基层卫生机构在卫生人员数量少、学历和职称偏低、待遇偏低、工作环境艰苦的条件下仍能提供绩效较全球、全国乡院平均水平更高的"六位一体"卫生服务,获当地患者较高满意度。②成都市卫生人员从一圈到三圈数量递减、学历和职称递降、配置不合理渐突出、服务难度递增等多种原因,导致卫生人员满意度从一圈到三圈逐渐下降。建议:①针对不同功能定位、工作类别的卫生机构或人员制定不同的绩效考核标准。通过多种培训、再教育方式保证现有卫生人员知识、临床技能不断更新。②整合区域卫生资源,建立长期、稳定的区域内上级卫生机构/人员帮扶制度、科学合理的双向转诊制度及指标体系。③晋级中应适当对基层单位倾斜,适度降低其晋级门槛,增加区域针对性和实际应用性的标准。
Objective To understand the current situation of Chengdu primary health workers＇ performance baseline, and to provide decision-making proof and policy recommendations for Chengdu Coordinated and Balanced Urban-rural Development as well as improve primary health workers＇ performance in China, Method See the second study in this series. Result The number of the patients of the Chengdu seven Rural Hospitals / Centers showed a trend of slow increase, and all was higher than the national rural hospital average level except the 2 most remote rural hospitals（＂Renhe＂ and ＂Bailu＂）. The seven Rural Hospitals / Centers could provide data about the ＂Six in One＂ work, and the performance was generally better than that of the world and the national average level, but showed a decreasing trend from the first circle to the third circle in Chengdu. The rate of patients＇ satisfaction and very satisfaction for the Rural Hospitals / Centers ＂Six in One＂ work reached 65%-80%, but the rate of health workers＇ job satisfaction and very satisfaction only reached 9%-46%,and also showed a decreasing trend from the first circle to the third circle. Conclusion The Chengdu primary health workers provide ＂Six in One＂ health service with a higher quality than the world and the national average levels. However, the number of the workers is less than enough; the human managerial structure is irrational; the educational and professional levels are low; their treatment and the work environment are poor. The distribution density, the academic qualification and the structure rationality of professional ranks of health personnel show a decreasing trend, and the difficulty of the service is gradually increasing from the first circle to the third circle, which causes the satisfaction rate of the workers＇ ）ob to decrease gradually from the first circle to the third circle. Suggestion： ① To make special performance assessment standard for special health institutions or personnel, and to give the continual oriented training chance for current health personnel. ② To integrate the regional health resources; to establish long-term and stable regional bilateral appointment help policy, technical and rational two-way referi＇al system and indicator systems. ③ To take measures to solve the problems affecting the professional promotion and improvement of the grass-root health personnel.
出处
《中国循证医学杂志》
CSCD
2008年第9期757-765,共9页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金面上资助项目(青年科学基金)(No.70503021)
成都市卫生局资助项目
