西安市社区卫生服务管理实践与研究

【作者】 高鹏；

【导师】 黄维民；

【作者基本信息】 西北大学 ， 公共管理， 2010， 硕士

【摘要】 本文详细介绍了社区卫生服务的历史沿革,社区卫生服务的目的、范围与对象,社区卫生服务的基本特点与原则及其运行模式；认真考察和参阅了国内外社区卫生服务的开展情况及相关资料,并通过国内外社区卫生工作开展的有代表性的国家和地区,此项工作现状、并对其存在问题,进行对比分析,提炼出一些可供参考的建议；结合作者对西安市社区卫生工作数年的实践、调研,对实践中发现的一些现象和问题,深入分析其成因,多层次多角度剖析；同时运用人口学、公共管理学、卫生经济学等理论对西安市社区卫生服务运行状况进行探讨,建议在服务模式、服务内容上有所创新,对如何更好地调动地方政府在社区卫生工作中的积极性等方面进行了论证,作者参加了2009年全国社区卫生工作会议,与多个省市的参会代表进行了深入交流、探讨,分析了全国22个社区卫生服务重点联系城市的运行现状,提出了西安市社区卫生服务可供选择的运行模式、对策措施。本文提出建立政府牵头的多元化建设思路；建议立足大卫生观念,打破现有卫生资源条块分割的格局,充分整合现有卫生资源,强化区域内医疗机构的有效联合与协作,构建以社区卫生服务机构为基础,以非营利性医疗机构为补充,分工合理、密切协作的新型城市卫生服务体系；对充分发动街道办事处(社区居委会)协助服务、引入第三方考核等管理框架以及如何最大限度的发挥社区卫生服务功能进行深入了探讨,希望对西安市社区卫生服务管理带来一些新的思路。更多还原

【Abstract】 In this thesis, the characteristics, basic theory and operation modes of community health service are presented, including its definition, goal, scope and objectives. The author has studied the development and the documentations of the community health service in China and also in other countries. By analyzing and comparing the development and the issues of the community health service of several domestic and foreign cities, the theories and experimental experiences have been summarized which can be introduced and utilized in our service provisioning. Based on many years’working and studying experience in the community health service in the city of Xi’an, this thesis has carried on the multi-level analysis on the existing problems and their causes from multiple perspectives. By using the theories of the public administrations, this thesis presents the innovations in the operation mechanisms, service framework and service contents. How to enhance the motivation of the government in the community health service provisioning is also studied. The author participated in the National Conference on Community Health Service in 2009, and had comprehensive discussions with the representatives from many cities and provinces. Through a series of illustrative case comparison of the national-wide 22 key cities, the feasible operation modes, policies and measures for the community health service in Xi’an have been proposed.This thesis proposes to establish the multi-support system led by the government, which is vital in the development of the community health service in Xi’an city. Based on the concept of global health service, by breaking the current block partition of the health resources and fully combining the resources, the correspondence and collaboration among the local health facilities can be further improved. Using the community health facilities to provide the basic services and the non-profit medical facilities to provide the complementary service, the new city health service system, which has more reasonable partition and closer cooperation, can be established. The operation frameworks and modes of how to fully utilize the support from the street administration office (community committee), to introduce the evaluation from the third party and to maximize the functionality of the community health services are also investigated thoroughly. This thesis provides in-depth insight and also useful innovative guidance in improving the community health services in Xi’an.更多还原