经济欠发达地区农村社区卫生服务模式探索

目的:介绍经济欠发达地区农村社区卫生服务模式并评价该模式对促进农村卫生工作和初级卫生保健的有效性。方法:通过开发领导、培训卫生人员、制定标准及完善制度、开发激励政策等方面对试点进行干预。选取江西省崇义县作为干预组,江西省芦溪县作为对照组。2009年6月和2010年6月分别对两地进行基线调查和追踪调查,评价其实施效果。结果:通过开展社区卫生服务,崇义县卫生机构公共卫生服务数量增加,村卫生机构在3岁以下儿童系统管理、孕产妇产后访视、慢性病人管理等方面开展比例分别由53.1%、51.2%、46.9%上升到77.8%,73.3%、71.1%,居民对医疗服务(就诊、住院)满意度提高;芦溪县没有明显变化。结论:建立了一种通过服务理念、服务模式的改变和激励政策的开发促进农村初级卫生保健工作的工作模式,这种模式适合于经济欠发达地区,政府投入不会太大,也不需涉及机构的转型和太多的体制问题,给欠发达地区农村卫生改革提供了启示和借鉴。

Exploring the mode of community health services in undeveloped rural areas in China

Objective To study the mode of community health services(CHS)in undeveloped rural areas,and evaluate its effectiveness to improve rural health services and primary health care.Methods Interventions were implemented in Chongyi County by developing leadership,training rural health practitioners,making standard,constructing system,and developing encouraging police.And Luxi County was chosen as control group.Based on baseline survey in 2009 and followed-up survey in 2010,the effect was evaluated.Results In Chongyi County,the number of public health services increased after implementing community health services.The ratio of health management system for children under 3 years old,postpartum visit and chronic disease management increased from 53.1%,51.2%and 46.9%to 77.8%,73.3%,and 71.1%,respectively.And the residents’satisfaction on medical services increased.While no significant change was observed in Luxi County.Conclusion A mode of CHS was developed,which was suitable to rural health services in undeveloped areas.And this mode can provide reference for other undeveloped rural areas.