上海市社区卫生全科团队配置及服务开展现况分析
Status Quo of Community General Practitioner Teams Configuration and Public Health Services Provision in Shanghai
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摘要:
目的 分析上海市社区全科服务团队配置及服务开展现况,为开展社区全科团队服务模式研究提供基础信息。 方法 发放调查问卷对全市所有社区卫生服务中心全科服务团队开展现况调查,进行计数、构成比和中位数等统计分析,比较市区、近郊区、远郊区社区全科服务团队设置、团队人员配备情况,对团队服务项目进行排序。 结果 全市96.62%的社区组建全科服务团队,团队地域(人口)配置达标率、每万人口专业人员配置达标率分别为59.83%、27.34%。每个团队平均服务人口0.96万人、服务里委(村)数3个、服务半径1.5 km、配备专业人员7人。地区配置平均水平存在差异,市区、近郊区、远郊区地域(人口)配置达标率分别为80.35%、55.81%、47.79%;每万人口专业人员标准配置达标率分别为6.07%、38.15%、34.95%;团队服务人口市区最多为1.65万,远郊区最少为0.53万;服务居委(村)市区最多为5个、远郊区最少为2个;服务半径市区最小为0.68 km,远郊区最大为2 km;团队人员配备也不一致,市区团队配备全科医生、护士、公卫医生各2人,近郊区全科医生和护士各2人、公卫医生1人,远郊区配备全科医生、护士、公卫医生各1人、乡村医生3人。示范点社区卫生全科团队平均开展服务项目23个,前20个项目中60%为慢病防治相关项目。 结论 社区基本完成全科团队组建,市区、近郊区、远郊区县团队配置存在差异,团队专业人员配备有待提高。全科团队开展以慢病防治为主的社区公共卫生服务。 Abstract:Objective To analyze the status quo of community general practitioner team configuration and public health services provision in Shanghai, to provide references and evidences for further model development of community general practitioner team. Methods Investigating all general practitioner teams of all community health centers in Shanghai by questionnaires and conducting relative statistical analysis such as counting, constituent ratio and median to compare the configuration and human resources of community general practitioner teams among central, suburban and exurban community health centers, and to sort the most frequently provided public health services in community. Results Of the community health centers in Shanghai 96.62% have built up general practitioner teams. The rates of reaching the standard in regional (population) configuration and professional staff configuration are 59.83% and 27.34% respectively. On average, each team serves for 9 600 community residents, 3 neighborhood committees/villages, with the service radius of 1.5 km. A general practitioner team usually has 7 members. Regional configuration difference is existed among community general practitioner teams. The rates of reaching the standard in the central, suburban and exurban areas are 80.35%, 55.81%, and 47.79% respectively. In reference to the national standard of allocating professional staff for every 10 000 residents, the rates of reaching the standard in central, suburban and exurban areas are 6.07%, 38.15%, 34.95% respectively. The community general practitioner teams serve as much as 16 500 residents per team in central areas, but as little as 5 300 residents per team in exurban areas. Each team serves 5 neighborhood committees/villages in central areas on average and 2 neighborhood committees/villages in exurban areas. The average service radius is 0.68 km in central areas while in exurban areas is 2 km. Further speaking, the teams in central areas usualy include 2 general practitioners, 2 nurses and 2 public health physicians, but the teams in suburban areas usualy include 2 general practitioners, 2 nurses and 1 public health physician, while the teams in exurban areas include only 1 general practitioner, 1 nurse, 1 public health physician and 3 village doctors. The model general practitioner teams provided 23 items of public health services on average, with 60% of the top 20 items were related to chronic disease prevention and control. Conclusion The construction of general practitioner team in community has almost finished in Shanghai. There are differences of team configuration among central, suburban and exurban communities and the configuration of professional staff should be improved. General practitioner teams provided public health services mainly on chronic disease prevention and control in community.
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