【摘要】 目的了解湖南某县农村基本公共卫生服务实施现状,探索农村基本公共卫生服务存在的困难和不足,并提出相应的对策。方法收集该县农村基本公共卫生服务项目实施的相关政策文件、月季年度报表、年度考核、年度总结报告等资料,并通过专题座谈会与关键人物访谈及抽样调查等获得相关资料。结果该县基本公共卫生服务实施组织架构健全,项目经费未达到国家要求,基层卫生服务人员队伍建设滞后,资金到位不及时。健康档案建档率79.6%、档案合格率84.0%;预防接种率98.4%;老年人体检率达94.7%,规范管理率34.6%;新生儿访视率93.2%,儿童管理率90.1%;产前服务率93.3%,产后访视率75.3%,5次及以上随访率为0.0%;高血压和糖尿病规范管理率分别为49.3%和55.4%,血压、血糖控制率为55%左右;重性精神疾病规范管理率64.7%,病情稳定率71.4%。结论该县基本公共卫生项目取得了一定成效,但合乎《项目服务规范》要求的比例低,存在服务质量不高、经费不足、拨付滞后、服务能力较差等问题。建议各部门提高认识,确保经费足额、及时到位,加强基层服务人员配备,同时规范服务流程,推进信息化进程,完善监管体系和绩效考核制度,促进基本公共卫生服务均等化的进程。更多还原

【Abstract】 Objective To investigate the current situation of implementing rural basic public health service in a county of Hunan Province,to explore its difficulties and insufficiencies,and to put forward the corresponding countermeasures. Methods We collected the data about implementing the rural basic public health service project in this county,including the related policies,monthly,quarterly and yearly reports,annual assessment and annual summary report; meanwhile,the relevant information was acquired through symposium,keyman interviews and sampling investigation. Results The rural basic public health service project in this county had a complete and regulated implementation organization framework,but the project funds could not meet the national requirements,the staff quality of the grass-roots medical institutions was poor and the funds were not available in time.The rate of health archive establishment was 79.6%,and the qualified rate of the archive was 84.0%. The immunization inoculation rate was 98.4%. The physical examination rate of senior citizens was 94.7%,and the standardization management rate was 34. 6%.The supervision rate of neonates was 93. 2%,and the management rate of children was 90. 1%. The antepartum service rate was93. 3%,the postpartum supervision rate was 75.3%,and the rate of the maternal who received 5 follow-ups and above during the pregnancy was 0.0%. The standardization management rates of hypertension and diabetes were 49.3% and 55.4% respectively,and the control rates of blood pressure and blood sugar were about 55%. The standardization management rate of severe mental illness was 64.7%,and the illness stability rate was 71.4%. Conclusions The rural basic public health service project in this county has obtained some achievements,but the proportion of meeting the requirements of the Project Management Standards is low,and there exist some problems like lower quality of the service,fund shortage,delayed disbursement of financing and poor basic public health service ability. We suggest that the relevant departments should raise awareness on services,ensure sufficient and available funds,strengthen the allocation of grass-roots medical staff,simultaneously standardize the service process,improve the informational proceeding and complete supervisory system and performance appraisal system so as to promote the process of equalization of basic public health services.更多还原