云南省城市社区卫生服务补偿机制现状及制约因素分析

目的：了解云南省社区卫生服务补偿机制的现状及建立健全补偿机制的制约因素。方法：采用问卷对昆明市、个旧市6个社区卫生服务机构各补偿渠道、补偿额度进行调查，并对两市的20名卫生行政管理、社区卫生工作人员进行知情者个人深入访谈。结果：云南省城市社区卫生服务的补偿来源包括差额拨款、专项经费、服务收入及药品收入4个渠道，所占比例分别为17．3％、4．0％、20．8％、58．0％；制约因素包括：缺乏必要的启动经赛；承担社区内大量的无偿服务，得不到相应补偿；社区卫生服务项目收费不规范；病源问题难于保障等。结论：云南省城市社区卫生服务补偿结构不合理，亟待调整与完善；针对调查中反映出来的制约因素，应加强研究，积极采取应对措施。

The Analysis on Current Status andMajor Problems of Compensation Mechanism of Community Health Services in Urban Area of Yunnan Province

Objective To understand current status and major problems of compensation mechanism of community health services (CHS) in Urban Area of Yunnan Province. Methods Questionnaire surveys were conducted to investigate compensation resources and compensation amount in 6 CHS institutes of Kunming and Gejiu; Key informant interviews were carried out towards 20 health managers and functionaries and medical staff. Results Compensation channels in Yunnan for CHS are composed of governmental difference allocation (17.3%), special funds(4. 0%), income from delivering services(20. 8%) and from drug(58. 0%) . Key factors constrained included shortage of necessary start outlay, inadequate reimbursement for public health services undertaken, irregular charge for community health services items and so on. Conclusions It is urgent to regulate compensation structure for CHS in Yunnan Province;Aimed at key factors found in the study,immediate measures should be taken to ensure sustainable development of CHS.