中国全科医学2012，Vol.15Issue(31)：3578-3580,3.DOI:10.3969/j.issn.1007-9572.2012.11.005
社区卫生收支两条线改革对社区首诊的作用研究
Revenue and Expenditure Separation Increases Rate of First Contact Care in Community Health Centers among Community Residents
摘要
Abstract
Objective To evaluate the impact of revenue and expenditure separation (RES) on rate of first contact care in community health centers (CHCs) among community residents. Methods Baseline household survey was conducted in February 2009 , before the implementation of RES, and endline household survey was conducted between July and August 2011, after the implementation of RES. According to the baseline and endline household survey results, residents who visited CHC within two weeks before the conduction of each survey were included in this study. This study employed a pre - post quasi - experiment design and independent variables were selected based on the Andersen model. Multiple regression models were used to i-dentify the impact of RES on first contact care. Results During the two weeks before the RES implementation, 31 community residents first sought care in CHC, out of 95 who had used medical services, and the figure after the RES implementation was 89 out of 146. Multiple regression analysis showed that the rate of first contact care in CHC increased by 28. 3% (P = 0.000) . Conclusion RES has improved the rate of first contact care in CHC among the community residents. RES helped attract community residents for two main reasons. First, CHCs start to be financed by the government instead of revenue from medication and medical services, so overtreatment is controlled and spending is reduced. Second, a series of medical personnel performance appraisal methods are introduced along with RES, which promote the provision of public health services.关键词
收支两条线/社区首诊/效果评价Key words
Separation of income and expenditure/ First health care in community/ Effect evaluation分类
医药卫生引用本文复制引用
郭泓,梁小云,金承刚..社区卫生收支两条线改革对社区首诊的作用研究[J].中国全科医学,2012,15(31):3578-3580,3.基金项目
首都医学发展科研基金(2007-2077) （2007-2077）
