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目的掌握江苏农村地区村级机构基本公共卫生服务开展情况及其影响因素。方法 2011年11—12月采用横断面调查的方法,对289所分布在江苏6个县级市的村级机构开展问卷调查,调查内容包括机构基本情况和11项基本公共卫生服务开展情况。结果村级机构实际服务人口是常住人口的1.06倍,29.3%(80/273)的机构实行了绩效工资制度改革,11项基本项目普遍开展,健康档案平均建档率为59.5%(2 173/3 650),婴幼儿健康管理开展率和2型糖尿病患者随访工作的开展率分别为73.7%(191/259)和94.5%(260/275)。溧阳和丹阳地区、服务人口数在3 850人及以上、项目经费补助在1.56万元/年及以上的机构健康档案建档人数和预防接种单发放数较多,缺少执业医师的机构建档人数较少,村医年均收入较高的机构预防接种单发放数较多,实行绩效工资制度改革的机构婴幼儿健康管理开展率较高,差异均有统计学意义(P<0.05)。结论基本公共卫生服务项目各项内容开展程度不一,保证项目经费补偿到位,加强基层卫生人员队伍建设和落实基层绩效工资制度改革,可促进基本公共卫生服务工作良性发展。
Objective To grasp the implementation of basic public health services at village level in rural areas of Jiangsu and its influencing factors. Methods From January to December in 2011, a cross-sectional survey was conducted to investigate 289 village-level agencies in 6 county-level cities in Jiangsu province. The survey included the basic situation of the institutions and the implementation of 11 basic public health services. Results The actual service population of village-level agencies was 1.06 times of the resident population. 29.3% (80/273) of the agencies implemented the reform of the performance pay system, and 11 basic projects were carried out. The average file rate of health records was 59.5% (2 173 / 3 650). The rate of follow-up on infant and child health management and type 2 diabetes was 73.7% (191/259) and 94.5% (260/275) respectively. Liyang and Danyang, with a service population of 3,850 and above, the number of institutional health records and vaccination orders issued by the project subsidy of 15,600 yuan / year and above is still high, and the number of institutional filing of practicing physicians lacks Fewer vaccines were issued to institutions with higher average annual incomes among village doctors, and infants and young children were more likely to be managed by institutions implementing the reform of the performance pay system. The difference was statistically significant (P <0.05). Conclusions The contents of basic public health service project are under varying degrees, and compensation for project funding is guaranteed. Strengthening the construction of grassroots health personnel and implementing the reform of grassroots performance pay system can promote the sound development of basic public health service.