Abstract: Objective　The development of public and private community health service centers（CHSCs） of Henan Province in 2012—2014 was comparatively analyzed in order to put forward the policy recommendation for the private community health service in Henan Province.Methods　The subjects of this study were all the public and private CHSCs in Henan Province from 2012 to 2014.The data of all public and private CHSCs in Henan Province in 2012—2014 from Information Statistics Center of Henan Provincial Health Bureau were analyzed,which included the number of public and private CHSCs,number of （assistant） practicing physicians and registered nurses,outpatient visits,number of people with emergency service and family service,health checkers,inpatients visits,number of beds,number of patients had dual referral between outpatient and hospitalization and so on.Results　From 2012 to 2014,in Henan Province,the proportion of public CHSCs decreased from 92.20% to 90.05% of all CHSCs,while that of private CHSCs increased from 7.80% to 9.95%.The proportion of （assistant） practicing physicians decreased from 91.04% to 89.46% of all practicing physicians in public CHSCs while that increased from 8.96% to 10.54% in private CHSCs.The proportion of registered nurses decreased from 90.14% to 88.20% of all registered nurses in public CHSCs while that increased from 9.86% to 11.80% in private CHSCs.The proportion of outpatient visits decreased from 86.81% to 83.85% of all outpatient visits in public CHSCs while that increased from 13.19% to 16.15% in private CHSCs.The ratio of patients with emergency service decreased from 86.00% to 78.83% in public CHSCs while that increased from 14.00% to 21.17% in private CHSCs.The proportion of patients with family service decreased from 88.34% to 76.37% of all patients with family service in public CHSCs while that increased from 11.66% to 23.63% in private CHSCs.The ratio of health checkers decreased from 83.31% to 81.99% of all health checkers in public CHSCs while that increased from 16.69% to 18.01% in private CHSCs.The proportion of inpatients visits increased from 92.79% to 93.15% of all inpatients visits in public CHSCs,whereas that decreased from 7.21% to 6.85% in private CHSCs.The proportion of number of beds decreased from 92.67% to 90.79% of all beds in public CHSCs,whereas that increased from 7.33% to 9.21% in private CHSCs.The proportion of outpatients of all outpatients who were transferred to higher level hospitals decreased from 75.33% to 71.55% in public CHSCs,while that increased from 24.67% to 28.45% in private CHSCs.The ratio of outpatients of all outpatients who were transferred to CHSCs decreased from 66.17% to 65.83% in public CHSCs,while that increased from 33.83% to 34.17% in private CHSCs.The proportion of inpatients of all inpatients who were transferred to higher level hospitals increased from 97.86% to 97.99% in public CHSCs,while that decreased from 2.14% to 2.01% in private CHSCs.Between 2012 and 2014,no inpatients were transferred to CHSCs in both public and private CHSCs.Conclusion　In Henan Province from 2012 to 2014,public CHSCs had more remarkable advantages in delivering outpatient and inpatient services,while private CHSCs played a more active role in providing emergency and family service.The outpatient dual referral mechanism was preliminarily established but inpatient dual referral mechanism had not been established in both public and private CHSCs.

Key words: Community health service centers, Hospitals,public, Hospitals,private, Henan

摘要： 目的　对比分析2012—2014年河南省公立与民营社区卫生服务中心的发展情况，为河南省社会办社区卫生服务提供政策建议。方法　以2012—2014年河南省所有公立与民营社区卫生服务中心为研究对象。对河南省卫生信息统计中心提供的2012—2014年全省公立与民营社区卫生服务中心的数据资料进行分析，包括公立与民营社区卫生服务中心的数量，执业（助理）医师、注册护士的数量，门诊、急诊、家庭服务、健康检查的人次数，住院人次数、床位数，门诊和住院双向转诊人次数等。结果　2012—2014年，河南省公立社区卫生服务中心数量占总数的比例从92.20%下降到90.05%；而民营社区卫生服务中心的比例从7.80%上升到9.95%。公立社区卫生服务中心执业（助理）医师、注册护士人数占总人数的比例分别从91.04%下降到89.46%、从90.14%下降到88.20%；而民营社区卫生服务中心的比例分别从8.96%上升到10.54%、从9.86%上升到11.80%。公立社区卫生服务中心门诊、急诊、家庭服务、健康检查人次数占总人次数的比例分别从86.81%下降到83.85%、从86.00%下降到78.83%、从88.34%下降到76.37%、从83.31%下降到81.99%；而民营社区卫生服务中心的比例分别从13.19%上升到16.15%、从14.00%上升到21.17%、从11.66%上升到23.63%、从16.69%上升到18.01%。公立社区卫生服务中心住院人次数、床位数占总数的比例分别从92.79%上升到93.15%、从92.67%下降到90.79%；而民营社区卫生服务中心的比例分别从7.21%下降到6.85%、从7.33%上升到9.21%。公立社区卫生服务中心门诊上转、下转人次数占总人次数的比例分别从75.33%下降到71.55%、从66.17%下降到65.83%；而民营社区卫生服务中心的比例分别从24.67%上升到28.45%、从33.83%上升到34.17%；公立社区卫生服务中心住院上转人次数占总人次数的比例从97.86%上升到97.99%，而民营社区卫生服务中心的比例从2.14%下降到2.01%；3年间住院下转人次数均为0。结论　河南省公立社区卫生服务中心在门诊、住院服务方面占据主导地位，但民营社区卫生服务中心在急诊、家庭卫生服务方面正发挥越来越大的作用；两类社区卫生服务中心门诊双向转诊的机制已初步建立，但住院双向转诊机制均未建立。

关键词: 社区卫生服务中心, 医院, 公立, 医院, 私立, 河南