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目的:观察2009年和2015年乡镇卫生院的竞争力变化,探讨其关键影响因素,为乡镇卫生院服务发展定位提供参考。方法:利用2010—2016“中国统计年鉴”、“中国卫生和计划生育统计年鉴”的数据,测算31个省份2009年和2015年乡镇卫生院服务份额水平及变化,用Pearson相关系数反映乡镇卫生院服务份额与相关因素的关系。结果:相较于2009年,2015年相关经济社会变量均大幅增长。2009年门诊份额与农村居民可支配收入正相关(r=0.39),与人均村医数量负相关(r=-0.39),2015年的相关无统计学意义;2009年住院服务份额与人均政府卫生投入和人均医院卫技人员数中度负相关(r=-0.58、-0.56),2015年则不再相关,与每千居民乡镇卫生院卫技人员数2009年不相关,2015年呈中度正相关。结论:新医改以来,乡镇卫生院门诊服务竞争力略有上升但住院竞争力明显下降,其服务竞争力和体系内上下游竞争者的关系以及与经济因素的关系均在减弱,转由人力资源和床位水平决定。要充分发挥乡镇卫生院的效能,关键是在界定服务功能基础上提升资源配置水。
OBJECTIVE: To observe the changes of competitiveness of township hospitals in 2009 and 2015, and to explore the key influencing factors, so as to provide reference for the service development of township hospitals. Methods: Using the data of 2010-2016 China Statistical Yearbook and China Health and Family Planning Statistical Yearbook, the level and changes of service share of township hospitals in 31 provinces in 2009 and 2015 were calculated. The Pearson correlation coefficient Reflect the relationship between the share of township hospitals and related factors. Results: Compared with 2009 and 2015, the relevant economic and social variables have increased substantially. The outpatient service share in 2009 was positively correlated with the disposable income of rural residents (r = 0.39), and negatively correlated with the number of village doctors per capita (r = -0.39), with no significant correlation in 2015. The share of inpatient services and per capita government health in 2009 There was a moderate negative correlation between the input and the number of health workers in the per-capita hospital (r = -0.58, -0.56), but no correlation in 2015, which was not related to the number of health workers per thousand inhabitants in township hospitals in 2009 and was moderate in 2015 Positive correlation. Conclusion: Since the new medical reform, the out-patient service competitiveness of township hospitals has slightly increased but the competitiveness of hospitals has decreased significantly. The service competitiveness and the relationship between upstream and downstream competitors as well as the relationship with economic factors have been weakened and transferred to human resources And bed level decision. To give full play to the effectiveness of township hospitals, the key is to improve the allocation of resources on the basis of defining service functions.