东莞市“政府办管”社区卫生服务模式的构建和效果评价研究

目的构建"政府办管"社区卫生服务模式,评价"政府办管"和"院办院管"模式的基本情况和运行效果。方法从2007年起,东莞市对社区卫生服务管理模式进行了改革,用"政府办政府管"模式代替"院办院管"模式。新管理模式运作3年后,分析比较2006年"院办院管"和2009年"政府办管"管理模式的运行效果。结果东莞市构建了具有东莞特色的"政府办管"社区卫生服务模式。效果评价显示:在"院办院管"模式下,平均每个镇街有7.6个社区卫生服务机构;"政府办管"模式下,平均每个镇街有10.8个社区卫生服务机构。"院办院管"模式下,分别有21.40%、10.70%、18.50%、38.70%和55.60%的社区卫生服务机构配置了中医诊室、康复诊室、儿童保健室、妇女保健室和健康教育室;而"政府办管"模式下,几乎所有社区卫生服务机构设置了以上公共卫生科室。"院办院管"模式下只有0.2%的医护人员取得全科医学培训证书,而"政府办管"模式下有32.55%的医护人员取得全科医学培训证书。结论东莞市"政府办管"社区卫生服务模式取得了较好的效果,值得进一步完善和推广。

Establishment and Effect of Community Health Services Model Managed by the Government in Dongguan City

Objective To establish the community health services(CHS) model managed by the government,and to evaluate the basic mode and operating effect of the models managed by the government and by the hospital.Methods The CHS model established and managed by general hospital had been replaced by the model by the government in Dongguan City since 2007.The operating effects of the model by general hospital in 2006 and by the government in 2009 or before and 3 years after the implementation of the new policy were compared.Results The CHS model established and managed by the government in Dongguan City was implemented successfully.The effect evaluation showed that there were 7.6 community health services institutions for each town under the model by the general hospital;while there were 10.8 community health services institutions for each town under the model by the government.There were 21.40%,10.70%,18.50%,38.70% and 55.60% of the institutions in which clinics of Traditional Chinese Medicine,rehabilitation,children′s health center,women′s health center and health education were established under the model by the general hospital;while all the clinics were established almost in all the institutions under the model by the government.Only 0.2% of the medical staff got the training certificate of general medicine under the model by the general hospital,while 32.55% got under the model by the government.Conclusion The effect of the community health services model established and management by the government in Dongguan City is satisfactory,which is worth improving and spreading.