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练璐, 曹冬丽, 李思清, 詹祥, 王萱萱. 基于供需双方视角的基本公共卫生服务项目效果评价[J]. 中国公共卫生, 2024, 40(5): 550-555. DOI: 10.11847/zgggws1143423
引用本文: 练璐, 曹冬丽, 李思清, 詹祥, 王萱萱. 基于供需双方视角的基本公共卫生服务项目效果评价[J]. 中国公共卫生, 2024, 40(5): 550-555. DOI: 10.11847/zgggws1143423
LIAN Lu, CAO Dongli, LI Siqing, ZHAN Xiang, WANG Xuanxuan. Evaluation of the provision and utilization of basic public health services in Jiangsu province: a cross-sectional online survey[J]. Chinese Journal of Public Health, 2024, 40(5): 550-555. DOI: 10.11847/zgggws1143423
Citation: LIAN Lu, CAO Dongli, LI Siqing, ZHAN Xiang, WANG Xuanxuan. Evaluation of the provision and utilization of basic public health services in Jiangsu province: a cross-sectional online survey[J]. Chinese Journal of Public Health, 2024, 40(5): 550-555. DOI: 10.11847/zgggws1143423

基于供需双方视角的基本公共卫生服务项目效果评价

Evaluation of the provision and utilization of basic public health services in Jiangsu province: a cross-sectional online survey

  • 摘要:
    目的 以人群健康水平提升为效果评价导向,开展基于供需双方的基本公共卫生服务项目效果评价调查研究,为持续完善国家基本公共卫生服务项目提供借鉴和参考。
    方法  于2022年8月采用多阶段分层抽样方法对江苏省苏南、苏中、苏北地区的1 682名基层医务人员和800名重点服务人群进行问卷调查,了解基层医务人员的基本公共卫生服务提供情况,以及对基本公共卫生服务提高本地居民健康水平效果的评价,了解居民的基本公共卫生服务利用情况及对服务提高健康水平的满意度评价。
    结果 共回收1 408份基层医务人员有效问卷和791份重点服务人群有效问卷。在服务提供方面,基层医务人员提供率较高的项目有:居民健康档案管理(73.0%)、健康教育(70.0%)、老年人健康管理(69.2%)、高血压患者健康管理(66.9%)和2型糖尿病患者健康管理服务(62.2%),且不同岗位基层医务人员对各项服务的提供率比较,差异均有统计学意义(均P < 0.05)。在0~10分评分标尺上,基层医务人员对各类基本公共卫生服务项目符合本地居民实际需求情况,以及提高本地居民健康水平情况的评价结果均 > 8分,其中评分排名前6位的项目(从前往后排序)均为:预防接种、高血压患者健康管理、老年人健康管理、2型糖尿病患者健康管理、0~6岁儿童健康管理和孕产妇健康管理;排名后6位的项目(从后往前排序)均为:中医药健康管理、卫生计生监督协管、严重精神障碍患者管理、肺结核患者健康管理、居民健康档案管理和健康教育。在重点人群服务利用方面,孕产妇对相应服务项目的利用率最高,为93.8%,慢性病患者及老年人的服务利用率相对较低,高血压患者、2型糖尿病患者、老年人的服务总体利用率分别为84.8%、77.1%和70.7%。91.7%的重点人群对相应服务提高健康水平的效果感到满意,其中老年人和2型糖尿病患者满意率相对较低,分别为89.0%和88.6%。
    结论 基本公共卫生服务项目在提升人群健康水平方面效果总体较好,结合供需双方评价发现,服务项目的实施形式和服务模式需要根据居民的健康需求持续优化,基层医务人员综合防治能力也有待提高,以进一步推动基本公共卫生服务高质量发展。

     

    Abstract:
    Objective To evaluate the provision and utilization of national basic public health services (BPHS) in Jiangsu province and to provide references for improving national basic public health service programs.
    Methods Using stratified multistage sampling and a self-designed questionnaire, we conducted an online survey in August 2022 among 1 682 employees of grassroots medical institutions (hospitals/community health centers/village clinics) and 800 residents of five groups who were key persons in need of specific health services covered by the national BPHS in three cities and three counties with different economic development in three geographical regions of Jiangsu province. Information on the provision and utilization of BPHS, and the impact of BPHS on meeting the health needs and improving the health status of the local population were collected and analyzed.
    Results Valid responses were obtained from 1 408 recruited medical staff and 791 recruited residents. The most common BPHS activity for medical staff was managing resident health records (reported by 73.0% of staff), followed by health education (70.0%), managing the health of the elderly (69.2%), managing patients with hypertension (66.9%), and managing patients with type 2 diabetes (62.2%). There were significant differences in BPHS activities among primary healthcare workers in different work positions (all P<0.05). The medical staff scored all 12 BPHS items higher than 8 on a scale with a maximum score of 10 in meeting the health needs and promoting the health status of the local population. The six items with higher scores (in descending order) were preventive immunizations, health management for hypertensive patients/elderly people/patients with type 2 diabetes/children aged 0-6 years, and maternal health management; whereas the six items with lower scores (in ascending order) were health management based on traditional Chinese medicine, co-management of health and family planning regulations, management of patients with severe mental disorders, health management of tuberculosis patients, management of residents' health records, and health education. Among the five groups of key persons in need of specific health services, pregnant women reported the highest utilization of BPHS (93.8%), while lower utilization was reported by hypertensive patients (84.8%), patients with type 2 diabetes (77.1%), and the elderly (70.7%). Overall, 91.7% of key persons in need of specific health services reported satisfaction with the BPHS in improving health status, but lower proportions of the elderly (89.0%) and patients with type 2 diabetes (88.6%) reported satisfaction.
    Conclusion The national BPHS generally showed good effects in improving the health status of the target population in the province. The evaluation of the delivery and utilization of the national BPHS suggests that the delivery mode and service model of the BPHS need to be optimized, and the professional capacity of grassroots health workers should be improved.

     

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