三级医院与社区卫生服务一体化管理的研究

摘要 目的 探索三级医院与社区卫生服务一体化管理模式。方法 采用样本住户随机抽取法，对吴江市盛泽镇3600户20周岁以上的常住居民，在实施三级医院与社区卫生服务一体化管理前后进行社区卫生服务质量封闭型问卷调查，观察时间1年。结果 三级医院与社区卫生服务一体化管理后，包括首诊选择、双向转诊、健康档案、慢性病管理、妇幼保健、健康教育、社区康复、基本医疗、社区卫生认知度、社区卫生服务满意度等质量指标有明显提高，健康知识知晓率、健康行为形成率有显著提升，差异有统计学意义(P＜0.001)。结论 三级医院--社区卫生一体化管理模式，能为社区居民提供优质、安全、满意、经济、方便的卫生服务，成效显著，具有重要示范和推广意义。

Exploration and Practice of Integrated Management in Hospitals of Third Grade and Community Health Service

In order to explore the integrated management model in hospitals of third grade and community health serv- ice, the authors of the article, by means of random selection in sample households, made the survey of close-type question- naire on service quality before and after the implementation of integrated management model in hospitals of third grade and community health service among 3,600 permanent residents above 20 years old in Shengze Town,Wujiang City. And the observation period lasted 1 year. They find that after the implementation of the integrated management model in hospitals of third grade and community health service, the quality indexes of the choice of the first medical treatment, dual referral, health records, management of chronic diseases, maternal and child health care, health education, community-based rehabili- tation, basic medical care, awareness of community health, and the satisfaction degree with community health are improved significantly, so are knowledge awareness rate and formation rate of healthy behaviors, whose difference has statistic signifi- cance（ P 〈 0. 001 ）. Thus the conclusion is made：the integrated management model in hospitals of third grade and commu- nity health service provides community residents with perfect, safe, satisfactory, economical and convenient health service, which has remarkable results and bears demonstrative and popularized significance.