社区卫生服务管理体制面临的挑战分析——基于六城区的抽样调查

目的：分析我国社区卫生服务管理体制面临的挑战。方法：运用焦点组访谈和个人深入访谈的方法收集六城区有关社区卫生服务管理体制的资料，并运用归纳总结的方法对定性资料进行分析。结果：区级政府作为举办主体理顺社区卫生服务管理体制存在困难；各级政府的事权与财力不相适应；卫生部门与其他部门的跨部门合作机制有待加强；社管中心成立的必要性与功能定位仍然悬而未决；如何管理社会资本举办的社区卫生机构有待进一步探索；缺乏居民参与管理的有效途径。建议：理顺政府相关部门之间的关系，促进财力与事权相匹配；建立有效的跨部门合作机制；制定和完善鼓励社会资本发展社区卫生的相关政策；进一步探索成立社管中心的可行性与必要性；探索和完善居民参与管理的有效途径。

Analysis on the challenges of administrative system of community health services: Based on the survey in 6 districts

Objective： To analyze the challenges of administrative system of community health services in China. Methods： To collect some qualitative data about community health governance from six districts through focus group discussion and in-depth interview and extract the main idea from the data. Results： District government as main body of community health institutions can＇ t smooth community health governance ; finance resource can＇ t follow with what community health institutions want to do, and financing responsibility of different government for community health institutions need to be identified; multi-sectors＇ cooperative mechanism needs to be improved; the feasibility and necessity of establishing community health managing center is still in suspense ; how to governance the community health institutions which were invested by social capital need further exploring; no institutions exited such as citizen participation in community health governance. Recommendations： Perfect the relationship between central government and local government; allocate money following with what community health institutions want to do; health sectors should play more important role in leading community health development and establish a multi-sector cooperative mechanism; consummate some policies related to community health institutions which were invested by social capital; explore the feasibility and necessity of establishing community health managing center continuously ; explore an effec- tive way to make citizens involved with community health governance.