两城市社区卫生服务中心儿童健康服务能力建设定性研究

王晰; 殷涛; 杨慧敏; 尹德卢

doi:10.16766/j.cnki.issn.1674-4152.002904

两城市社区卫生服务中心儿童健康服务能力建设定性研究

doi: 10.16766/j.cnki.issn.1674-4152.002904

王晰¹,
殷涛²,
杨慧敏²,
尹德卢^2, ,

1.
首都医科大学附属北京儿童医院儿童慢病管理中心，北京 100037
2.
首都儿科研究所儿童卫生发展研究室，北京 100020

基金项目:

北京市医院管理局青年人才培养“青苗计划”项目 QML20161301

详细信息

通讯作者:
尹德卢, E-mail: deluyin@126.com

中图分类号: R197.61 R179
计量
- 文章访问数: 282
- HTML全文浏览量: 150
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-16
- 网络出版日期: 2023-04-19

Qualitative study on capacity construction of children's health service in community health service centers in two cities

WANG Xi¹,
YIN Tao²,
YANG Huimin²,
YIN Delu^{2
, ,}

1.
Beijing Children's Hospital, Capital Medical University, Beijing Chronic Disease Management for Children, Beijing 100037, China

摘要

摘要: 目的为满足儿童健康服务快速增长的需求，解决我国社区卫生服务中心儿童健康服务综合能力薄弱的问题，总结成都、厦门两地社区卫生服务中心儿童健康服务能力建设的经验，为加强我国基层医疗卫生机构儿童健康服务能力提供参考。方法 2020年6—11月，采用方便抽样，对厦门、成都两市5家社区卫生服务中心儿童健康服务相关工作者进行半结构性访谈研究，共纳入研究24人；应用MAXQDA软件，按照主题编码、归类，进行归纳性的描述、整理和分析。结果定性研究结果提示：(1)在资源投入方面，两市虽与全国的社区卫生服务中心相同，存在儿科医生数量少的问题，但注重现有儿科医生的能力提升，同时发挥全科医生在儿科中的作用，儿童相关设备设施及药品的投入较为完善。(2)在服务产出方面，儿童诊疗服务能力强，特色服务项目多元化使儿童家庭签约服务率高。(3)在服务效果方面，适宜的绩效分配方案使得工作人员收入水平高，综合全面的健康服务使得患儿家长满意度提高。结论厦门、成都两城市社区卫生服务中心儿童健康服务能力强，得益于政策的大力支持、人员的充分利用以及发展具有当地特色的儿童健康服务。
- 社区卫生 /
- 儿童健康服务 /
- 定性研究
Abstract: Objective In order to meet the rapid growth of children's health services and solve the problem of weak comprehensive capacity of children's health services in community health service centers in China, summarize the experience of children's health service capacity building in community health service centers in Chengdu and Xiamen, and provide reference for strengthening the children's health service capacity of primary medical and health institutions in China. Methods Convenient sampling was used to conduct semi-structured interviews with children's health service workers in five community health service centers in Xiamen and Chengdu from June to November 2020, including 24 participants. The MAXQDA software was used to encode and classify according to the subject, and to describe, sort out and analyze the subject. Results (1) In terms of resource input, although the two cities were the same as the national community health service centers, there was a problem of a small number of pediatricians, but they focused on improving the capacity of existing pediatricians, while giving play to the role of general practitioners in pediatrics, and the investment in children's related equipment, facilities and drugs was relatively perfect. (2) In terms of service output, children's diagnosis and treatment service capacity were strong, and the signing service rate of children's families was high. (3) In terms of service effect, the appropriate performance distribution scheme made the income level of staff high, and comprehensive health services improved the satisfaction of children's parents. Conclusion Community health service centers in Xiamen and Chengdu have strong ability to provide children's health services, which benefit from the strong support of policies, the full use of staff and the development of children's health services with local characteristics.
- Community health /
- Children's health services /
- Qualitative research

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表 1 案例中心访谈对象基本情况(n=24)

Table 1. Basic information of interviewees in case center (n=24)

基本情况	人数(%)
地区
成都市	10(41.67)
厦门市	14(58.33)
职业类型
儿科医生	5(20.83)
全科医生	8(33.33)
儿保医生	5(20.83)
其他	6(25.00)
性别
男性	12(50.00)
女性	12(50.00)

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表 2 主题及分支子主题

Table 2. Themes and branch subthemes

主题	子主题
1.案例中心的能力建设情况	(1)案例中心儿科医务人员数量不充裕，但重视人员素质能力的提升，积极发挥全科医生的作用
	(2)案例中心儿科诊疗设备设施齐全且先进
	(3)案例中心儿科常用药配备充足
2.案例中心服务产出情况	(1)案例中心提供儿童健康服务项目种类多，提供综合、连续、可及的儿童健康服务
	(2)案例中心儿童健康签约服务量大
3.案例中心服务效果情况	(1)案例中心工作人员服务积极性高，收入水平高
	(2)案例中心患者签约率高，患者满意度高

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参考文献(15)

[1]	王晰, 殷涛, 政晓果, 等. 基层儿童健康服务能力评价指标体系探索[J]. 中国卫生经济, 2020, 39(5): 60-63. https://www.cnki.com.cn/Article/CJFDTOTAL-WEIJ202005017.htm WANG X, YIN T, YIN D L, et al. Study on evaluation index system of primary children's health service capacity[J]. Chinese Health Economics, 2020, 39(5): 60-63. https://www.cnki.com.cn/Article/CJFDTOTAL-WEIJ202005017.htm
[2]	秦江梅, 林春梅, 张丽芳, 等. 我国基层医疗卫生机构儿科资源及医疗服务能力现状研究[J]. 中国全科医学, 2019, 22(13): 1511-1515. doi: 10.12114/j.issn.1007-9572.2019.00.214 QIN J M, LIN C M, ZHANG L F, et al. Research on pediatric resources and medical service capacity of primary health care institutions in China[J]. Chinese General Practice, 2019, 22(13): 1511-1515. doi: 10.12114/j.issn.1007-9572.2019.00.214
[3]	查达永, 邵小飞, 周霞, 等. 广州市白云区儿童保健服务供给状况定性分析[J]. 中国妇幼保健, 2019, 34(10): 2182-2185. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201910002.htm ZHA D Y, SHAO X F, ZHOU X, et al. Qualitative analysis on the supply of child health care services in baiyun district of guangzhou[J]. Maternal and Child Health Care of China, 2019, 34(10): 2182-2185. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201910002.htm
[4]	国家卫生健康委员会. 2019中国卫生健康统计年鉴[M]. 北京: 中国协和医科大学出版社, 2019. National Health Commission. 2019 China Health Statistics Yearbook[M]. Beijing: China Union Medical University Press, 2019.
[5]	刘宇春, 杜雪平, 丁静, 等. 0~3岁儿童社区儿科门诊就诊需求研究[J]. 中国全科医学, 2020, 23(16): 1996-2001. doi: 10.12114/j.issn.1007-9572.2019.00.704 LIU Y C, DU X P, DING J, et al. Needs Assessment of Pediatric Outpatient Clinic in Community for Children Aged 0-3[J]. Chinese General Practice, 2020, 23(16): 1996-2001. doi: 10.12114/j.issn.1007-9572.2019.00.704
[6]	范立萍, 弥曼, 李雪萍, 等. 西安市全科医生对于儿童普通感冒的诊疗认知及其影响因素研究[J]. 中华全科医学, 2019, 17(10): 1714-1717. doi: 10.16766/j.cnki.issn.1674-4152.001038 FAN L P, MI M, LI X P, et al. A Study of the diagnostic perception of the primary care physicians in Xi'an city concerning of the common cold among the children and the influencing factors[J]. Chinese Journal of General Practice, 2019, 17(10): 1714-1717. doi: 10.16766/j.cnki.issn.1674-4152.001038
[7]	王晰, 殷涛, 杨慧敏, 等. 我国27家社区卫生服务中心儿童诊疗服务投入产出效率分析[J]. 中华医院管理杂志, 2021, 37(2): 167-171. WANG X, YIN T, YIN D L, et al. Input-output efficiency analysis for children's diagnosis and treatment service at 27 community health service centers in China[J]. Chinese Journal of Hospital Administration, 2021, 37(2): 167-171.
[8]	国家卫生计生委, 国家发展改革委, 教育部, 等. 关于加强儿童医疗卫生服务改革与发展的意见. (国卫医发〔2016〕21号). [EB/OL]. (2021-05-12)[2022-01-22]. http://www.beijing.gov.cn/zhengce/zcjd/201905/t20190523_77515.html. National Health and Family Planning Commission, National Development and Reform Commission, Ministry of Education, Ministry of Finance, Ministry of Human Resources and Social Security, National Administration of Traditional Chinese Medicine. Suggestions on strengthening the reform and development of children's medical and health services. (National Health Care & Medical Development[2016] 21). [EB/OL]. (2021-05-12). http://www.beijing.gov.cn/zhengce/zcjd/201905/t20190523_77515.html.
[9]	刘曼玲, 姚文柱, 冯巩. 建国70年以来我国社区卫生服务的发展[J]. 中华全科医学, 2019, 17(8): 1251-1254, 1311. doi: 10.16766/j.cnki.issn.1674-4152.000914 LIU M L, YAO W Z, FENG G. The development of community health service in 70 years since the foundation of the People's Republic of China[J]. Chinese Journal of General Practice, 2019, 17(8): 1251-1254, 1311. doi: 10.16766/j.cnki.issn.1674-4152.000914
[10]	梁彤彤, 刘贻曼, 丁克颖, 等. 上海市闵行区社区卫生服务中心公共卫生服务人员职业倦怠和工作投入现状及其关系[J]. 职业与健康, 2019, 35(19): 2610-2613, 2617. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK201919005.htm LIANG T T, LIU Y M, DING K Y, et al. Relationship between job burnout and job engagement among public health workers in community health service centers in Minhang district, Shanghai[J]. Occupation and Health, 2019, 35(19): 2610-2613, 2617. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK201919005.htm
[11]	朱伟娇. 基层0~6岁儿童健康管理服务现状分析及儿童健康问题调查结果[J]. 中西医结合心血管病电子杂志, 2017, 5(25): 166-167. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH201725123.htm ZHU W J. Current status of health management services for children aged 0-6 years and results of investigation on children's health problems[J]. Cardiovascular Disease Journal Of integrated traditional Chinese and Western Medicine, 2017, 5(25): 166-167. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH201725123.htm
[12]	国家卫生健康委. 国家卫生健康委关于印发健康儿童行动提升计划(2021—2025年)的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2021(10): 28-32. Notice of the National Health Commission on the issuance of the Healthy Children Action Promotion Plan (2021-2025)[J]. Bulletin of National Health Commission of the People's Republic of China, 2021(10): 28-32.
[13]	曾明亮. 社区卫生服务中心绩效评价体系分析[J]. 商讯, 2019, 4(21): 131-132. https://www.cnki.com.cn/Article/CJFDTOTAL-SYJW201921077.htm ZENG M L. Analysis of performance evaluation system of community health service centers[J]. Business News, 2019, 4(21): 131-132. https://www.cnki.com.cn/Article/CJFDTOTAL-SYJW201921077.htm
[14]	刘诗逸, 辛军国, 田军, 等. 成都高新区社区卫生服务中心人事绩效体系改革效果评价[J]. 中国卫生事业管理, 2019, 36(7): 489-491, 512. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWSG201907007.htm LIU S Y, XIN J T, TIAN J, et al. Evaluation on the Reform of Personnel Performance System in Community Health Service Center of Chengdu High-tech Zone[J]. Chinese Health Service Management, 2019, 36(7): 489-491, 512. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWSG201907007.htm
[15]	人力资源社会保障部, 财政部, 国家卫生计生委, 等. 关于开展公立医院薪酬制度改革试点工作的指导意见(人社部发〔2017〕10号)[EB/OL]. (2021-05-12)[2022-01-23]. http://www.scio.gov.cn/32344/32345/39620/39749/xgzc39755/Document/1646190/1646190.htm. Ministry of Human Resources and Social Security, Ministry of Finance, National Health and Family Planning Commission, National Administration of Traditional Chinese Medicine. Guidance on the Pilot Reform of the Compensation System in Public Hospitals (Issued by the Ministry of Human Resources and Social Security[2017] No. 10)[EB/OL]. (2021-05-12). http://www.scio.gov.cn/32344/32345/39620/39749/xgzc39755/Document/1646190/1646190.htm.