包头市社区卫生服务改革研究

【作者】 刘震；

【导师】 马宝成；

【作者基本信息】 中央民族大学 ， 公共管理， 2011， 硕士

【摘要】 礼区卫生服务是最为基本、最为普通的一种基层卫生服务,是满足城市居民基本卫生服务需求的理想卫生保健服务模式,在提供便捷、综合、协调、价廉、质优的卫生服务方面具有很大的优势,不仅大大提高了卫生服务的服务效率,而且在保障基本医疗和控制医疗卫生费用增长及提高居民健康水平方面起到了卓有成效的作用。2009年10月,内蒙古自治区召开医药卫生体制改革工作会,传达了《关于深化医药卫生体制改革实施意见》和《关于深化医药卫生体制改革近期重点实施方案》的有关精神,对此次医改中各级政府工作进行了安排部署,并与各盟市签订了医改责任状。包头市成立了市医改领导小组办公室,各旗县区也成立了相应机构。目前,包头市社区卫生服务机构网络已初具规模。然而,城区的社区卫生服务仍存在诸多的发展难题,社区医院设置、服务机构设备、技术力量以及个性化服务等,在满足市民日益增长的高层次医疗保健需求方面还存在相当差距。如今,政府确定建立居民步行15分钟就能到达社区卫生机构的社区卫生服务网络,显然在为居民提供更加安定、祥和的生活环境与和谐社会的建立上都具有深远的意义。在社区卫生服务发展过程中,得到了社会各界和各级政府的支持和帮助,但仍然存在着对社区卫生服务的重要性认识不深、不透；政府领导、部门协调、街道负责、社区参与、卫生部门实行行业管理的社区卫生服务管理体制虽然明确,但在实际操作中,职责、相互关系还没有全部理顺。在市场经济条件下和激烈的市场竞争中,服务理念滞后,表现为经营管理理念不到位,服务态度生硬,医疗技术不精；和卫生资源供不应求的矛盾日趋激烈,部分群众对社区卫生服务的认识有盲点,一味追求无偿卫生服务的大有人在；还有少部分群众认为只要我付钱,卫生机构就应该提供所需的一切服务。这些认识上的偏差,忽视了社会主义初级阶段卫生机构的现状。医疗卫生属于公益性、福利性事业,但是政府补偿机制还没有到位,如果没有市场化运作的有偿服务,卫生机构本身也将无法生存和发展。如果只要付钱就能满足一切需求,一级医疗机构尚未完全具备这些服务功能与技术能力。目前,发展社区卫生服务的方向,只能在符合社会主义初级阶段基本国情前提下,为社区群众提供综合、可及、连续、方便、经济、有效、基本的卫生服务。更多还原

【Abstract】 Community health service is the most basic and common grass-root service, as well as an ideal health care service mode to satisfy the basic health care needs of the urban citizens. It has a great advantage in providing convenient, comprehensive, compatible, high quality and affordable health service, which not only significantly improves the efficiency of health service, but also makes great contribution in ensuring basic medical service, controlling health care expenditure and improving citizen’s health level. In September of 2009, a working conference on Health Care Mechanism was held in Inner Mongolia municipality, in which, the concepts of two documents, the Implementation Opinions on intensifying Medical and Health Service and The Implementation Plan for the Recent Focus Point on Intensifying Medical and Health Service Reform, was conveyed, and also relevant arrangements was made to all levels of government involved in this medical reform, and signed Medical Reform Responsibility Declaration with each alliance-city. Baotou city has founded Medical Reformation Office while each flag counties have also founded corresponding organizations. Till now Community health services network of Baotou has already taking shape. However, there are still several developing problems in the country’s Community health services such as Community hospital setting, Service equipment as well as Technical force and personalized service etc. there still exists disparity in meeting the growing medical care needs. Nowadays, the government has already determined to build network which ensures the residents can arrive the Community health organization within 15 minutes. Therefore, it has profound significance in providing the residents and the whole community as well as the society with more peaceful and harmonious life.Although we get lots of support and assistance from the Public and the Government during the process of Community Health Service, there still exist the lack of the deep recognition to the importance of the Community Health Service. Although community health service management system with the Government leadership, Interdepartmental coordination, Street responsibility, Community participation as well as Health authorities implementation has already set up, the obligation and the correlations has not been totally rationalized during the process of operation. Under the market economy condition and the fierce competition in the market, the Laggard service concept represents itself as the deficiency of the Management philosophy, the bad Service Attitude and the lack of the Medical Technology; also the shortage of the health resource comparing the demand is becoming increasingly fierce, Part of the masses’ understanding of the community health services in a blind spot, majority of people just blindly seek unpaid health service; and some minority own the viewpoint that they have the right to get all the service as long as they have paid the money.All such cognitive biases are caused by the neglect to the status quo of public health service at the primary stage of Socialism. Medical and public health service is a welfare undertaking which is beneficial to public interests. However, due to poor government compensation mechanism, public health service can not develop, or even survive, without engaging compensatory service via marketing operation. Therefore, even first-class medical institutions do not possess the service functions and technologies to fulfill the mission of satisfying all needs from people as far as they pay. Currently, the development of community health service shall based on the basic notional conditions at the primary stage of Socialism, providing the community with a basic comprehensive health services which are accessible, consecutive, convenient, economical and effective.更多还原