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目的了解沈阳市基层医疗卫生服务机构的资源现况,分析基层医疗卫生机构存在的问题,探讨解决问题的方法。方法 2015年8月向沈阳市所有基层医疗卫生服务机构发放问卷,进行问卷调查,使用构成比、百分率、χ2检验及秩和检验等对沈阳市基层医疗卫生机构各指标进行分析。结果共调查沈阳市基层医疗卫生机构2 914家,社区卫生服务中心分布为市区163家、郊区81家、县市0家。在岗人员职称情况:高级职称341人(占4.01%),中级职称2 411人(占28.33%)。市区职称高于郊区,县市最低(P<0.001)。在岗人员学历情况:本科及以上学历1 713人(占20.13%),专科学历2 274人(占26.72%)。本科学历,市区多于郊区,县市地区最少(P<0.001)。市区的社区卫生服务机构的CR、DR、超声设备和生化分析仪的设备配备率分别为3.07%、8.59%、31.91%和32.52%,高于郊区和县市,乡镇卫生院仪器配备率分别为22.97%、12.16%、87.84%和87.84%,高于市区和郊区。结论市区及郊区的基层医疗卫生状况相对较好,下辖县市地区处于相对低水平状态,政府需要加大扶持力度。
Objective To understand the current status of primary health care services in Shenyang, analyze the existing problems of primary health care institutions, and explore ways to solve the problems. Methods A questionnaire was sent to all primary health care institutions in Shenyang in August 2015 to conduct a questionnaire survey. The indicators of primary health care institutions in Shenyang were analyzed using composition ratio, percentage, χ2 test and rank sum test. Results A total of 2 914 primary health care institutions were surveyed in Shenyang. The community health service centers were distributed in 163 urban areas, 81 suburban areas and 0 counties. Positions in positions: 341 senior professional (accounting for 4.01%), mid-level 2 411 (28.33%). Urban job title is higher than the suburbs, the lowest county (P <0.001). Education background: 1 713 (20.13%) with bachelor degree or above and 2 274 (26.72%) with college degree or above. Bachelor degree, more urban areas than suburbs, counties and cities in the least (P <0.001). The equipment availability rates of CR, DR, ultrasound equipment and biochemical analyzer in community health service agencies in urban areas were 3.07%, 8.59%, 31.91% and 32.52% respectively, higher than those in suburbs and counties 22.97%, 12.16%, 87.84% and 87.84% respectively, higher than the urban and suburban areas. Conclusions Primary health care in urban areas and suburbs is relatively good, and counties and cities under the jurisdiction are in a relatively low level. The government needs to increase its support.