中国全科医学 ›› 2018, Vol. 21 ›› Issue (25): 3051-3055.DOI: 10.12114/j.issn.1007-9572.2018.25.005

• 专题研究 • 上一篇    下一篇

新医改前后武汉市社区卫生服务中心经济运行状况分析

乔家骏1,曾旖旎2*   

  1. 1.100033北京市,中国人民健康保险股份有限公司 2.100019北京市,国家卫生计生委能力建设和继续教育中心
    *通信作者:曾旖旎;E-mail:474810059@qq.com
  • 出版日期:2018-09-05 发布日期:2018-09-05

Economic Performance of Community Health Centers in Wuhan before and after the China's Health Care Reform Lauched in 2009 

QIAO Jia-jun1,ZENG Yi-ni2*   

  1. 1.PICC Health Insurance Company Limited,Beijing 100033,China
    2.National Health Commission Capacity Building and Continuing Education Center,Beijing 100019,China
    *Corresponding author:ZENG Yi-ni;E-mail:474810059@qq.com
  • Published:2018-09-05 Online:2018-09-05

摘要: 目的 了解新医改前后武汉市社区卫生服务中心的经济运行状况。方法 根据2008—2016年武汉市卫生财务年报,对武汉市社区卫生服务中心收支情况、服务量、服务效率和效益进行分析。结果 2008—2016年武汉市社区卫生服务中心总收入年均增长率为21.4%,可分配结余为负值,且可分配负结余规模有持续扩大趋势。财政补助收入占总收入比重持续增长,由2008年的32.4%增长至2016年的60.0%,其中用于公共卫生服务补助的资金年均增长率为7.7%;医疗收入占总收入比重大体上呈下降趋势,由2008年的59.4%降至2016年的37.7%,其中药品收入占医疗收入比重由2008年的38.9%降至2016年的32.3%。承担的门急诊人次数由2008年的200.5万人次增长至2014年的398.8万人次,2015、2016年分别降至359.2、298.4万人次;出院人数由2008年的1.2万人增长至2014年的7.3万人, 2015、2016年分别降至5.3、4.1万人。病床使用率由2009年为80.9%下降至2016年的44.4%,百元固定资产医疗收入(不含药品收入)由2008年的61.2元增长至2011年的135.1元,之后大体上呈下降趋势,2016年降至66.9元。结论 新医改以来,武汉市社区卫生服务中心的经济运行发展低于全国平均水平;公共卫生服务功能有所增强,但医疗服务功能弱化;建议持续提升社区卫生服务中心的医疗服务能力,调动社区人员积极性,提升工作效率,最终促进分级诊疗实现。

关键词: 社区卫生中心, 经济运行, 武汉

Abstract: Objective To analysis the economic performance of community health centers in Wuhan before and after the China's health care reform lauched in 2009.Method Income and expenditure,patients flows,efficiency and effectiveness of health service provision of Wuhan community health centers were analyzed by using Health Financial Annual Report 2008—2016 in Wuhan.Results Annual average growth rate of total income in Wuhan community health centers was 21.4% during 2008—2016,and distributable balances were below zero in a continuous expansion trend.The share of government subsidy increased from 32.4% in 2008 to 60.0% in 2016,of which subsidy for public health services increased by 7.7%;the proportion of medical income was generally declining,from 59.4% in 2008 to 37.7% in 2016,of which the proportion of drug income fell from 38.9% in 2008 to 32.3% in 2016.The number of outpatient and emergency visits increased from 2.005 million in 2008 to 3.988 million in 2014,and decreased to 3.592 and 2.984 million in 2015 and 2016 respectively.The number of discharged patients increased from 12 000 in 2008 to 73 000 in 2014,and fell to 53 000 and 41 000 in 2015 and 2016 respectively.The utilization rate of beds decreased to 44.4% by 2016 from 80.9% in 2009.The income from medical insurance for 100 yuan fixed assets(excluding drug income) increased from 61.2 yuan in 2008 to 135.1 yuan in 2011,in a generally decline trend.It fell to 66.9 yuan in 2016.Conclusion Economic operation of Wuhan community health centers was lower than the national average since the China's health care reform lauched in 2009;the public health service function has been enhanced,but the medical services function has been weakened.We recommend continuously improving the medical service capacity of community health centers and mobilizing the enthusiasm of community staff to improve work efficiency and ultimately promote hierarchical diagnosis and treatment.

Key words: Community health centers, Economic preformance, Wuhan