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目的对农村地区卫生服务质量跟踪、评估及监管机制的证据现状进行文献计量分析,以促进农村卫生服务质量的有效评估和监管,优化资源配置,提高农村医务人员的卫生服务质量和水平。方法计算机检索Pub Med、The Cochrane Library(2016年第3期)、The Campbell Library、Web of Science、CBM、CNKI、Wan Fang Data数据库及卫生政策研究相关网站,检索时间截至2016年3月。纳入农村卫生服务跟踪、评估或监管机制的文献。采用End Note X7与Excel 2007进行文献筛选和数据分析。结果共纳入39篇文献,其中:横断面研究18篇(46.2%),综述18篇(46.2%),群随机试验2篇(5.1%),随机对照研究1篇(2.6%);发表于SCI收录期刊13篇(33.3%),中国核心期刊3篇(7.7%),普通期刊18篇(46.2%),学位论文5篇(12.8%)。涉及的理论模型包括:机制10种(12篇,30.8%),框架4种(7篇,18%),体系11种(12篇,30.8%),方法 12种(12篇,30.8%)。使用范围针对村卫生室3篇(7.7%),乡镇卫生院3篇(7.7%),社区2篇(5.1%)。研究内容包括:公共卫生19篇(48.7%),医疗卫生16篇(41%),医疗保险4篇(10.3%)。结论农村卫生服务质量跟踪、评估及监管机制的研究尚缺乏系统性、针对性和实用性,且现有证据级别偏低。建议重视和加强农村卫生服务质量跟踪、评估及监管机制研究,为推动农村卫生服务质量的有效评估和监管提供有效证据,以促进农村卫生资源的合理优化配置,最大程度地提高农村卫生服务的质量和水平。
OBJECTIVE To document and analyze the status quo of tracking, assessing and monitoring the evidence of health service quality in rural areas so as to promote the effective assessment and supervision of rural health service quality, optimize the allocation of resources and improve the quality and level of health services for rural medical staff. Methods The databases of Pub Med, The Cochrane Library (2016 Issue 3), The Campbell Library, Web of Science, CBM, CNKI and Wan Fang Data were searched by computer. The search time was up to March 2016. Documentation for tracking, assessing or monitoring rural health services. EndNote X7 and Excel 2007 were used for literature review and data analysis. Results A total of 39 articles were included, including 18 cross-sectional studies (46.2%), 18 reviews (46.2%), 2 randomized controlled trials (5.1%) and 1 randomized controlled trial (2.6%). There were 13 journals (33.3%), 3 core journals in China (7.7%), 18 regular journals (46.2%) and 5 dissertations (12.8%). The theoretical models involved include 10 mechanisms (12 articles, 30.8%), 4 articles (7 articles, 18%), 11 articles (12 articles, 30.8%) and 12 articles (12 articles, 30.8%). The scope of application is 3 village clinics (7.7%), 3 township hospitals (7.7%) and 2 communities (5.1%). The research contents include 19 public health (48.7%), 16 health care (41%) and 4 medical insurance (10.3%). Conclusion The research on tracking, assessing and supervising the quality of rural health services is still lacking in systematicness, pertinence and practicability with low level of available evidence. It is suggested to pay attention to and strengthen the research on the follow-up, assessment and supervision mechanism of rural health service quality so as to provide effective evidence to promote the effective assessment and supervision of rural health service so as to promote the reasonable and optimal allocation of rural health resources and to maximize the quality of rural health services And level.