高级检索
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. 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. DOI: 10.11847/zgggws1143423
LIAN Lu, CAO Dongli, LI Siqing, ZHAN Xiang, WANG Xuanxuan. Effectiveness evaluation of basic public health service programs from the perspectives of supply and demand[J]. Chinese Journal of Public Health. DOI: 10.11847/zgggws1143423
Citation: LIAN Lu, CAO Dongli, LI Siqing, ZHAN Xiang, WANG Xuanxuan. Effectiveness evaluation of basic public health service programs from the perspectives of supply and demand[J]. Chinese Journal of Public Health. 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

Effectiveness evaluation of basic public health service programs from the perspectives of supply and demand

  • 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 enhance the level of population health as an evaluation guide, this study conducted an effectiveness evaluation survey on basic public health services from the perspectives of both supply and demand, providing references and guidance for the continuous improvement of national basic public health service programs.
    Methods In August 2022, a multi-stage stratified sampling survey was carried out among 1 682 primary healthcare workers and 800 key service population in southern, central, and northern Jiangsu province to understand the provision of basic public health services by primary healthcare workers and their evaluation on the effects of these services on improving local residents′ health levels. Additionally, the utilization of basic public health services by residents and their satisfaction with the health improvements provided by these services were assessed.
    Results A total of 1 408 valid questionnaires from primary healthcare workers and 791 valid ones from key service population were collected. Among the services provided, those with higher provision rates were: management of resident health records (73.0%), health education (70.0%), elderly health management (69.2%), hypertension patient health management (66.9%), and type 2 diabetes patient health management services (62.2%). There was a statistically significant difference in the provision rates of various services among primary healthcare workers of different positions (all P < 0.05). On a 0-10 point rating scale, primary healthcare workers rated all categories of basic public health services as more than 8 points in terms of meeting local residents′ actual needs and improving their health levels. The top six programs (in descending order of rating) were preventive vaccination, hypertension patient health management, elderly health management, type 2 diabetes patient health management, health management for children aged 0-6, and maternal health management; the bottom six (in ascending order) were traditional Chinese medicine health management, health and family planning regulatory co-management, management of patients with severe mental disorders, tuberculosis patient health management, resident health record management, and health education. Regarding the utilization of services by key populations, the highest rate was found among pregnant women at 93.8%, while service utilization was relatively lower among patients with chronic diseases and the elderly, with overall utilization rates of 84.8%, 77.1%, and 70.7% for patients with hypertension, type 2 diabetes, and the elderly, respectively. A total of 91.7% of the key service population were satisfied with the improvement of health levels by respective services, with relatively lower satisfaction rates among the elderly and type 2 diabetes patients at 89.0% and 88.6%, respectively.
    Conclusion The basic public health service programs generally show good effects in improving population health levels. Based on the assessment by supply and demand sides, it is found that implementation forms and service models need continuous optimization according to residents' health needs, and the comprehensive prevention and treatment capability of primary healthcare workers also needs enhancement to further promote the high-quality development of basic public health services.

     

/

返回文章
返回