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目的对上海市实施社区卫生服务中心降低医疗费用,引导服务重心下沉社区的效果进行分析。方法选择三家社区卫生服务中心,分析2006年2月-2007年12月,门诊总人次数、初诊人数、次均门诊费、次均门诊药费等数据。随机抽取308名社区患者问卷调查,内容有基本情况,对减免门诊诊查费的了解程度、就诊次数、费用变化、就诊去向。结果三中心2007年与2006年同期相比,门诊总人次数增加27.0%～16.7%,次均门诊费、次均门诊药费分别下降13.6%～11.4%、11.0%～5.5%,差异均有统计学意义(P<0.05),初诊患者增加8.6%、4.9%、10.7%。问卷调查76.3%调查者认为门诊费低廉,91.9%认为是政府解决群众“看病难、看病贵”的举措。结论实施降费后,居民就医经济负担减轻,初诊患者增加。此举有利于社区卫生服务的发展,社区居民得到更好的服务。
Objective To analyze the effect of implementing community health service center in Shanghai to reduce medical expenses and guide service center to sink community. Methods Three community health service centers were selected to analyze the data such as the total number of outpatients, the number of newly diagnosed patients, the average outpatient fees and the average outpatient medical expenses from February 2006 to December 2007. A total of 308 community-based questionnaires were randomly selected. The content of the questionnaire was based on the basic situation, the degree of understanding of the out-patient examination fees, the number of visits, the cost changes, and the direction of the visit. Results The number of outpatients increased by 27.0% -16.7% in 2007 compared with the same period in 2006. The average outpatient fees and outpatient out-patient medicines dropped by 13.6% ~ 11.4% and 11.0% ~ 5.5% respectively, with a significant difference Statistical significance (P <0.05), the newly diagnosed patients increased 8.6%, 4.9%, 10.7%. Questionnaire survey 76.3% of respondents think that out-patient fees are low, 91.9% think it is the government to solve the masses “difficult to see a doctor, expensive doctor ” measures. Conclusion After the implementation of the drop in fees, the residents’ financial burden on medical care is reduced and the number of newly diagnosed patients is increased. This move is conducive to the development of community health services, community residents get better service.