摘要
目的:分析国家基本公共卫生服务项目实施进展与公平性,为项目持续发展提供参考。方法:在安徽、河南和重庆调查15个区县的所有社区卫生服务中心和乡镇卫生院,分析基本公共卫生筹资、人员配置和服务提供进展,并以基尼系数分析公平性改善情况。结果:基本公共卫生服务经费逐年提高,2011年人均筹资标准已超过25元/人/年;基层公共卫生人员数量有所增加,但人员配置相对不足且公平性有待提高;服务提供公平性有所改善,妇幼保健服务相对较好,高血压和糖尿病规范化管理明显改善。结论:基本公共卫生筹资可能存在"隐性不公平",基层公卫人员配置相对不足,服务提供实效性有待提升。建议重视项目成本测算,加强基层人才队伍建设,合理确定服务项目,建立以质量为导向的绩效考核机制,创新基层公共卫生服务模式等。
Objectives： In this paper, we discuss the development and equity of national essential public health services, and provide references for the sustainable development of these services. Methods ： We analyzed financing, staffing, and service delivery at community and township health centers in 15 counties in Anhui, Henan, and Chongqing. We calculated the Gini coefficient to evaluate equity. Results： We found that financing for essential pub- lic health services has gradually increased and that subsidies were more than RMB 25 per capita in 2011. The quanti- ty of personnel in primary health care institutions had increased, but personnel needed to be distributed more equita- bly. Primary health care services, in particular, child and maternal health services, were being more equitably pro- vided. Management of hypertension and diabetes had also been standardized to a much greater extent. Conclusions： Some imbalances still remain in the financing of essential public health care, and there is still a shortage of trained public health care staff. Service delivery also needs to be continually improved. We recommend paying more attention to cost estimates of essential public health services, training and developing health care staff, and making well-con- sidered decisions about which services to focus on. We also recommend establishing a quality-oriented performance e- valuation mechanism and innovating on the service-delivery model.
出处
《中国卫生政策研究》
CSCD
2013年第5期9-14,共6页
Chinese Journal of Health Policy
基金
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"
关键词
基本公共卫生服务
公平
筹资
人力资源
卫生服务提供
Essential public health services
Equity
Financing
Health workforce
Health service delivery
