本文選題：社區(qū)衛(wèi)生服務(wù) + 資源配置�。� 參考：《武漢大學(xué)》2017年碩士論文

【摘要】：醫(yī)藥衛(wèi)生事業(yè)是關(guān)乎億萬人民的偉大事業(yè),是解決我國民生問題的重要保障之一。近幾年我國一直在探索醫(yī)藥衛(wèi)生體制改革,改革至今處于深化的攻堅(jiān)階段,建設(shè)社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)有助于攻破醫(yī)改屏障。同時在現(xiàn)代社會居民疾病譜發(fā)生重大變化的背景下,人們對于疾病預(yù)防越來越重視,社區(qū)衛(wèi)生服務(wù)成為公共服務(wù)領(lǐng)域建設(shè)的熱點(diǎn)。因此,社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)建設(shè)成為我國目前建設(shè)基層醫(yī)療衛(wèi)生服務(wù)體系的重點(diǎn),需要完善以社區(qū)衛(wèi)生服務(wù)為基礎(chǔ)的新型醫(yī)療衛(wèi)生服務(wù)體系,加快建設(shè)城市社區(qū)衛(wèi)生服務(wù)網(wǎng)絡(luò),使之承擔(dān)起保障居民健康的"守門"職責(zé)。我國社區(qū)衛(wèi)生服務(wù)立足于初級衛(wèi)生保健,以社區(qū)居民健康為中心,致力于提供基礎(chǔ)性、預(yù)防性、綜合性的全科醫(yī)療服務(wù),有利于我國病有所醫(yī)目標(biāo)的實(shí)現(xiàn)。在國家的倡導(dǎo)、支持下,近年來我國社區(qū)衛(wèi)生服務(wù)事業(yè)蓬勃發(fā)展,服務(wù)機(jī)構(gòu)數(shù)量大幅度增加,衛(wèi)生醫(yī)療資源得到極大的擴(kuò)充。武漢市政府立足于廣大市民,在認(rèn)真、深刻貫徹新醫(yī)改要求的前提下,對于建設(shè)社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)非常重視,先后在2010年和2013年發(fā)布相關(guān)文件在全市范圍內(nèi)督促建設(shè)、完善社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu),明確要求打造15分鐘社區(qū)衛(wèi)生服務(wù)圈,力爭取得初步建成居民社區(qū)首診制,切實(shí)減輕居民醫(yī)療負(fù)擔(dān)的效果。在此基礎(chǔ)上本文考察武漢市的社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)按照文件標(biāo)準(zhǔn)進(jìn)行建設(shè)后的狀況,以資源配置為維度,對其是否取得滿意的效果進(jìn)行分析。研究結(jié)果表明:目前的建設(shè)沒有取得預(yù)期的效果,社區(qū)首診制尚未實(shí)現(xiàn),就診人數(shù)沒有顯著增加,居民診治負(fù)擔(dān)沒有得到明顯減輕。但起到了一定的改善作用,比如人力資源方面:切實(shí)擴(kuò)充居民可獲得的醫(yī)護(hù)資源、促進(jìn)管理作用的發(fā)揮,管理層有所壯大;物力資源方面:衛(wèi)生服務(wù)可及性有所提高、醫(yī)療技術(shù)力量進(jìn)一步增強(qiáng);財(cái)力資源方面:政府財(cái)政投入重視度提高。但由于建設(shè)時只重視數(shù)量的擴(kuò)充,忽視對質(zhì)量的追求,另外,缺乏監(jiān)管,落實(shí)不到位。存在一些不足,具體表現(xiàn)為:人力資源方面,衛(wèi)生技術(shù)人員結(jié)構(gòu)不合理現(xiàn)象沒有改善(包括學(xué)歷、職稱、編制結(jié)構(gòu));物力資源方面,機(jī)構(gòu)區(qū)域布局存在不公平性、醫(yī)療服務(wù)資源利用率和衛(wèi)生設(shè)備工作效率未達(dá)到標(biāo)準(zhǔn);財(cái)力資源方面,落實(shí)不理想以及補(bǔ)貼、補(bǔ)償標(biāo)準(zhǔn)偏低,社區(qū)衛(wèi)生機(jī)構(gòu)經(jīng)營惡劣。針對不足,結(jié)合武漢市社區(qū)衛(wèi)生服務(wù)建設(shè)實(shí)際情況,提出相應(yīng)的改良建議和針對性的實(shí)施策略,以期優(yōu)化社區(qū)衛(wèi)生服務(wù)資源配置,更好地提高武漢市社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)的服務(wù)水平,實(shí)現(xiàn)社區(qū)首診制的初步形成,切實(shí)減輕居民醫(yī)療負(fù)擔(dān)。
[Abstract]:Medical and health care is a great undertaking related to hundreds of millions of people and an important guarantee to solve the livelihood problems of our country. In recent years, China has been exploring the reform of the medical and health system. The reform is still in the stage of deepening, and the construction of community health service institutions will help to break through the barrier of medical reform. At the same time, people pay more and more attention to disease prevention under the background of great changes of disease spectrum in modern society. Community health service has become a hot spot in the field of public service. Therefore, the construction of community health service institutions has become the focus of our country's current construction of primary medical and health service system. It is necessary to improve the new medical and health service system based on community health service, and speed up the construction of urban community health service network. To assume the responsibility of safeguarding the health of the residents, "gatekeepers". The community health service in our country is based on primary health care, taking the health of community residents as the center, and devoting to providing basic, preventive and comprehensive general medical service, which is conducive to the realization of the goal of treating diseases in our country. With the support of the government, the community health service in China has developed rapidly in recent years, the number of service institutions has increased greatly, and the health and medical resources have been greatly expanded. Based on the general public, the Wuhan Municipal Government, under the premise of conscientiously and profoundly implementing the requirements of the new medical reform, attaches great importance to the construction of community health service institutions, and successively issues relevant documents in 2010 and 2013 to urge the construction of the project throughout the city. Improve the community health service institutions, explicitly request to create a 15-minute community health service circle, strive to achieve the initial establishment of community first visit system, effectively reduce the burden of medical care for residents effect. On this basis, this paper investigates the situation of the community health service institutions in Wuhan after construction according to the document standard, and analyzes whether the community health service institutions in Wuhan have achieved satisfactory results from the perspective of resource allocation. The results show that the present construction has not achieved the expected effect, the community first visit system has not been realized, the number of patients has not increased significantly, and the burden of diagnosis and treatment has not been significantly reduced. But it has played a certain role in improving, for example, in terms of human resources: to effectively expand the health care resources available to residents, to promote the role of management, the management has grown; material resources: health services have increased accessibility, Medical technical strength further enhanced; financial resources: government financial investment increased attention. But because the construction only pays attention to the quantity expansion, neglects the pursue to the quality, in addition, lacks the supervision, the implementation is not in place. There are some shortcomings, such as: human resources, unreasonable structure of health technical personnel (including academic qualifications, professional titles, compilation structure), unfairness in the regional distribution of institutions in the area of material resources, The utilization rate of medical service resources and the working efficiency of sanitary equipment did not reach the standard; in the aspect of financial resources, the implementation was not ideal and subsidies, the compensation standard was low, and the operation of community health institutions was poor. According to the actual situation of community health service construction in Wuhan, the paper puts forward corresponding improvement suggestions and targeted implementation strategies in order to optimize the allocation of community health service resources. To improve the service level of community health service institutions in Wuhan, to realize the initial formation of community first visit system, and to lighten the burden of residents' medical treatment.
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1

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