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目的探讨合同购买重点卫生服务的适宜技术。方法应用社会学评估方法,对试行合同购买卫生Ⅷ项目重点卫生服务1年以上的某项目县运行情况进行现场调查分析。结果合同购买重点卫生服务在试点县3所县级卫生机构和11所乡镇卫生院得到有效实施;合同任务基本实现;合同购买方式不但可以规范直接面向需方提供服务的财务行为,而且是社区落实卫生干预活动行之有效的管理手段;基层实施合同购买重点卫生服务操作程序应简便,监管指导要到位。结论合同购买重点卫生服务试点是成功的,项目推行的购买程序和管理技术对于政府改变公共卫生的直接财政投入方式可提供借鉴。
Objective To explore the appropriate technology for contract purchase of key health services. Methods The sociological assessment method was used to carry out on-site investigation and analysis of the operation of a certain county where the contract of purchase of key health services of Ⅷ project was procured for more than one year. Results Key health services purchased in the contract were effectively implemented at three county-level health agencies and 11 township clinics in Pilot County; the contractual tasks were basically fulfilled; and the contract purchase method not only regulated the financial behaviors that directly served the demanders, but also implemented the communities Health interventions effective management tools; grass-roots implementation of the contract to purchase key health services should be simple operating procedures, supervision and guidance to be in place. Conclusion The pilot purchase of key health services by contract is successful. The purchase procedure and management techniques promoted by the project can provide reference for the government to change the direct financial input of public health.