不同类型社区卫生服务中心公共卫生服务功能分析

目的:分析武汉市30家不同举办主体社区卫生服务中心公共卫生服务功能的发挥情况。方法:利用加权秩和比法和数据包络分析分别从公共卫生服务的开展情况和提供效率两个方面对社区卫生服务中心进行评价。结果:(1)政府办、社会办和医院办社区卫生服务中心平均WRSR值分别为0.525、0.481和0.539(经检验,差别无统计学意义),3类社区卫生服务中心公共卫生服务总体开展情况差异不大;(2)3类社区卫生服务中心在不同公共卫生服务项目开展上各有侧重,并且各项基本公共卫生服务工作落实情况不同,居民健康档案建档工作开展率高于0~6岁儿童和65岁以上老年人健康管理率。(3)政府办社区卫生服务中心公共卫生服务提供综合效率(0.770)高于社会办和医院办社区卫生服务中心(0.705和0.698)。结论:鼓励和支持社会办社区卫生服务中心发展,通过合理监管,促进其公共卫生服务职能有效发挥;卫生行政部门应完善公共卫生服务考核方式,引导各类社区卫生服务中心公共卫生服务工作均衡开展;社会办和医院办社区卫生服务中心应进一步改善公共卫生服务效率,提高技术水平,在合理配置资源的基础上适度增加投入。

The Analysis of Service Function of Public Health of Community Health Centers Held by Different Sponsors

Objective To analyze the status of public health service of 30 community health centers (CHS) held by different sponsors in Wuhan. Methods Using Rank-sum ratio and Data Envelopment Analysis to compare different types of CHSs from aspects of launching rate and efficiency of public health service. Results The WRSR of community health centers held by government, society and hospital are 0.525, 0.481 and0.539 respectively. There are no significant gaps between different types of community health centers at the aspect of launching rate; The three kinds of CHS focus on different public health items, and the launching rate of residents health files is higher than system administration rates of child under age 6 and old people above 60 years old; The supplying efficiency of public health service held by government is better than the other two types of CHS. Conclusion Different social forces should be encouraged to improve the system of community health center and promote the development of public health service. The evaluation modes of public health items should be improved and health administrations ought to direct CHSs implementing different public items in balance. CHSs held by society and hospitals should improve the supplying efficiency and technical level of public health services and increase input moderately on the basis of reasonable allocation of resources