刘志会+何思长+赵大仁+张瑞华

摘 要 目的：分析2010—2014年我国社区卫生服务中心发展情况及存在问题，为进一步提高社区卫生资源配置与利用效率提供依据。方法：通过研究2010—2014年的中国卫生统计年鉴，对全国所有社区卫生服务中心的机构数、卫生技术人员数、床位数、万元以上医疗设备及门急诊人次和平均住院日等数据进行描述性分析。结果：社区卫生服务中心整体实力不断增强，但人力资源、万元以上医疗设备、资产负债率等仍较为薄弱，且其病床使用率较低，平均住院日有待缩短，卫生服务利用效率不高。结论：继续加大对社区卫生服务的软、硬件方面投入，完善人才培养机制，提高居民信任度，引导居民在社区首诊，促进和形成分级诊疗的良好就医格局。

关键词 CHS；卫生资源；配置；利用

中图分类号：R197.1 文献标志码：A 文章编号：1006-1533（2017）14-0016-04

Analysis of health resource allocation and service utilization of community health service centers in China from 2010 to 2014

LIU Zhihui， HE Sichang， ZHAO Daren， ZHANG Ruihua

（Management School， Chengdu University of Traditional Chinese Medicine， Chengdu 610075， Sichuan Province， China）

ABSTRACT Objective： To analyze the development situation and existing problems of community health service centers from 2010 to 2014 to provide the reference for further improving the allocation and utilization efficiency of community health resources. Methods： Through the study of the 2010—2014 China Health Statistics Yearbook， the number of institutions， the number of health workers， the number of beds， the medical equipment， the number of outpatient and emergency visits， the average length of hospital etc. of all community health service centers in China were descriptively analyzed. Results： The overall strength of the community health service centers has been enhanced， but human resources， medical equipment of more than ten thousand Yuan， the rate of assets and liabilities etc. were still relatively weak. The hospital bed utilization rate was low， the average length of stay would be shortened， and health service utilization efficiency was not high. Conclusion： We will continue to increase investment in hardware and software of community health services， improve the mechanism of personnel training， improve residents confidence， guide the residents first visit in the community， and promote and form a good medical treatment pattern of grading diagnosis and treatment.

KEY WORDS community health service； health resource； configure； utilization

提高醫疗卫生资源配置的公平性及其利用效率是医疗卫生制度改革的重点，也是政府优化医疗卫生资源配置的目标[1]。2015年《国务院办公厅关于推进分级诊疗制度建设的指导意见》中提出“以强基层为重点，完善分级诊疗服务体系，是合理配置医疗资源、促进基本医疗卫生服务均等化的重要举措”[2]，社区卫生服务中心（Community Health Service，CHS）作为基层首诊的第一站，其诊疗服务能力备受各方关注。本文通过分析 2010—2014年全国CHS的资源配置与利用情况，探讨其存在的问题，为促进形成基层首诊、双向转诊、急慢分治、上下联动的分级诊疗制度提供参考依据。……