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目的:通过对余姚市县乡医疗资源功能整合改革效果的调查分析,提出进一步推广的建议。方法:使用自制调查表对余姚市临床检验中心、16家乡镇卫生院和80名居民进行了问卷调查,与当地卫生行政、发改部门和基层医疗机构负责人进行了小组座谈。结果:与试点前相比,乡镇卫生院平均门急诊人次数增加了12%,平均住院人次数增加了6%,平均住院手术人次数增加了20%。从2009到2011年,临床检验中心业务收入明显增加,人员经费和材料费占业务收入的比例从90.3%下降到62.7%。有97.5%的居民更信任现在的检验结果,96.3%觉得费用比以前下降了。结论:余姚市医疗资源功能整合改革提升了基层医疗机构的服务能力和质量,降低了就医成本,提高了资源利用效率,促进了综合性医院和基层医疗卫生机构的功能互补,适合在经济发达、交通便利的地区优先推广,同时通过加大财政转移支付力度帮助欠发达地区逐步推广。
Objective: Through the investigation and analysis of the functional integration and reform of medical resources in Yuyao county and township, suggestions for further promotion are put forward. Methods: We conducted a questionnaire survey of Yuyao Clinical Laboratory Center, 16 township hospitals and 80 residents using the self-made questionnaire, and held panel discussions with the heads of local health administrations, development and reform departments and grass-roots medical institutions. Results: Compared with the pre-trial, the average number of emergency attendants in township hospitals increased by 12%, the average number of inpatients increased by 6%, and the average number of hospitalized patients increased by 20%. From 2009 to 2011, the business income of the clinical testing center increased significantly, while the proportion of personnel and material expenses in business income dropped from 90.3% to 62.7%. 97.5% of residents trust the current test result more, and 96.3% think the cost has dropped than before. Conclusion: The functional integration reform of medical resources in Yuyao City has improved the service ability and quality of primary medical institutions, reduced the cost of medical treatment, improved the efficiency of resource utilization, promoted the complementary functions of general hospitals and primary health care institutions, Convenient areas to give priority to promote the same time by increasing financial transfer payments to help less developed regions gradually promote.