深圳市院办院管模式运行现状及改革试点措施研究

目的全面了解深圳市院办院管模式的运行现状，分析社区健康服务中心改革试点措施的实施效果。方法对3个区麸计65家社区健康服务中心进行问卷调查，同时深入访谈相关知情人。结栗深圳市社区健康服务中心诊疗服务量占全市诊疗量的比重由2004年的20．0％上升至2010年的31．3％．门诊次均诊疗费用则由2005年的59．1元下降至2010年的45．6元。调研地区2009年门诊次均费用水平均低于全国平均水平。差异具有统计学意义（P=0．000）。结论深圳市社区健康服务中心网络已基本实现社区全覆盖和人口全覆盖．社区健康服务中心的改革试点进一步完善了院办院管模式的运行机制和管理架构。

Research on Current Situation and Pilot Reform Measures of Hospital-establishing and Hospital-managing Mode in Shenzhen

Objective To investigate the current situation of-hospital-establishing and hospital-managing mode in Shenzhen, and analyze effectiveness of community health service center pilot reform. Methods Questionnaire investigation was made in sixty-five community health service centers in three sampled districts. In-depth interviews with related departments were also done to make qualitative analysis. Results In terms of overall level in Shenzhen, the percentage of medical service provided by community health service centers increased from 20.0% in 2004 to 31.3% in 2010, meanwhile, outpatient expense per visit decreased from 59.1 yuan in 2005 to 45.6 yuan in 2010. Outpatient expense per visit were all significantly lower than that of national average level with difference having statistical significance （P= 0.000）. Conclusion Community health service centers network in Shenzhen has basically achieved complete coverage for community and population. Community health service center pilot reform has further improved operational mechanism and management structure of hospital-establishing and hospital-managing mode.