| 引用本文: |
黄冬梅,尹文强,于倩倩,等.基于目标人群服务份额的乡镇卫生院服务竞争力研究[J].中国卫生经济,2017,(8):44-48.[点击复制] |
.The analysis on competitiveness of township health centers-Based on service shares in target market[J].CHINESE HEALTH ECONOMICS,2017,(8):44-48.[点击复制] |
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| 摘要: |
| 目的：观察2009年和2015年乡镇卫生院的竞争力变化，探讨其关键影响因素，为乡镇卫生院服务发展定位提供参考。方法：利用2010-2016中国统计年鉴、中国卫生和计划生育统计年鉴的数据，测算31个省份2009和2015年乡镇卫生院服务份额水平及变化，用Pearson相关系数反映乡镇卫生院服务份额与相关因素的关系。结果：相较于2009年，2015年相关经济社会变量均大幅增长，政府卫生支出增长、医院床位和医院卫生技术人员的人均水平分别增长了190.0%、62.5%、54.2%，每千农村居民卫生院卫技人员数仅增长28.6%；乡镇卫生院门诊服务份额提高4.1个百分点，住院服务份额下降14.9个百分点；2009年门诊份额与农村居民可支配收入正相关（r=0.39），与人均村医数量负相关（r=-0.39），2015年的相关无统计学意义；2009年住院服务份额与人均政府卫生投入和人均医院卫技人员数中度负相关（r=-0.58、-0.56），2015年则不再相关，与每千居民乡镇卫生院卫技人员数2009年不相关，2015年呈中度正相关。结论：新医改7年来，乡镇卫生院门诊服务竞争力略有上升但住院竞争力明显下降，其服务竞争力和体系内上下游竞争者的关系以及与经济因素的关系均在减弱，转由人力资源和床位水平决定。医疗服务体系内部竞争弱化，分工合作是大势所趋。要充分发挥乡镇卫生院的效能，关键是在界定服务功能基础上提升资源配置水平。 |
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| The analysis on competitiveness of township health centers-Based on service shares in target market |
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| Abstract: |
| Objective: To observe the evolution of township health centers (THCs) competitiveness during 2009-2015, explore the key factors of the change, and provide reference for the development of township hospitals. Methods: Using provincial data from China health statistics yearbook to calculate the service share in target population of THCs in 2009 and 2015, Pearson correlation coefficient was used to measure the relationship between service share and related factors. Results: Compared to 2009, the relevant economic and social variables had increased significantly in 2015. The per-capita level of government expenditure on health, number of hospital beds and health personnel increased 190%, 62.5% and 54.2%. The outpatient service shares of THCs increased 4.1%, and the inpatient service shares decreased 14.9%. The share of outpatient service was positively correlated with per capita disposable income of rural inhabitants (r=0.39), and negatively correlated with the village doctors per 1000 rural inhabitants (r=-0.39) in 2009 but was no statistical significance in 2015. The share of inpatient service was moderate negative correlated with per capita government health expenditure (r=-0.58) and per capita number of hospital staff (r=-0.56) in 2009 but was not relevant in 2015, THCs personnel per 1000 rural inhabitants was not related with inpatient shares in 2009, but was moderate positive correlative in 2015. Conclusion：Since 2009, the competitiveness of outpatient service of township hospitals increased slightly, but the competitiveness of hospitals declined significantly. The factors affecting THCs competitiveness showed great change, the competitive relationship with competitors in medical system were weakening, so did its relationship with the economic factors. The competitiveness of THCs mainly depends in human resource and hardware. The future development orientation of THCs should focus on enhancing human and hardware resources on the basis of reasonable position in health system. |
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