社区卫生服务论文：社区卫生服务绩效评价指标体系德尔菲专家咨询法数据包络

社区卫生服务论文：社区卫生服务绩效评价指标体系德尔菲专家咨询法数据包络
【中文摘要】发展社区卫生服务是健全我国医疗保障体系,保障公共卫生服务供给公平性和可及性的重要举措,近年来各地区社区卫生服务工作发展迅速,成效显著。

目前,全国已设立社区卫生服务中心(站) 27308个。

社区卫生服务医护人员29.5万人,床位数101448张。

仅以2009年为例,全国社区卫生服务中心提供诊疗人次为2.6亿人次,入院人数164.2万人;平均每个中心年诊疗人次5.0万人次,年入院人数315人,全国社区卫生服务站提供诊疗人次1.2亿人次,平均每站提供年诊疗人次5259人次,社区卫生服务成为了缓解百姓“看病难,看病贵”现象的有效手段。

正是由于社区卫生服务在完善医疗保障体系中所起的重要作用,因此需要对各个社区卫生服务机构工作开展情况进行综合评价,发现工作过程中存在的问题和不足,深入分析问题产
生原因并总结经验,为社区卫生服务的可持续发展提供决策依据,从
而进一步促进社区卫生服务健康快速发展。

为此,围绕社区卫生服务绩效评价研究,本研究共分为五个部分:第一部分阐述了本研究的主要。

即在借鉴国内外专家学者研究的基础上,通过对沈阳市和平区各个社区卫生服务机构工作开展情况进行调查研究,建立一套符合实际的、操作性强的社区卫生服务绩效评价指标体系,以促进社区卫生服务机构进一步改进工作、提高管理水平,为政府主管部门制定相关政策措施提供有力支持。

第二部分介绍了社区卫生服务绩效评价工作的
基本理论。

掌握社区卫生服务绩效评价工作的相关基本理论是建立社区卫生服务绩效评价指标体系的基础,通过界定社区卫生服务绩效评价的相关概念,全面了解国内外社区卫生服务绩效评价研究的现状,明确社区卫生服务绩效评价的内容、原则和标准,为建立社区卫生服务绩效评价指标体系提供理论指导。

第三部分建立了社区卫生服务绩效评价指标体系。

该部分是本研究的核心内容,本研究通过综合运用文献复习、实地调查等多种方法,初步提出了社区卫生服务绩效评价指标体系备选指标,在此基础上,开展两轮Delphi专家咨询法对备选指标进行筛选并确定指标的权重,最终建立社区卫生服务绩效评价指标体系。

第四部分是在建立社区卫生服务绩效评价指标体系的基础上进行实证研究。

本研究以沈阳市和平区社区卫生服务工作开展情况作为研究对象,按照筛选出的指标,收集和平区9个社区卫生服务中心2010年工作开展情况的相关数据,并在对指标体系的信度和效度进行检验后,通过数据包络分析法(DEA)对9个社区卫生服务中心的工作开展情况进行综合评价并加以分析,对评价结果较差的社区卫生服务中心提出改进工作的意见建议。

第五部分提出了改进社区卫生服务绩效,发展社区卫生服务工作的对策建议:一是要进一步加强社区卫生服务的绩效管理;二是政府对社区卫生服务投入要有刚性保证;三是要建立健全社区卫生服务的筹资与补偿机制;四是要完善社区卫生服务功能,有效提高社区卫生服务质量;五是要继续加强社区卫生服务人才引进和培养工作;六是要积极推动社区卫生服务的机制体制创新。

【英文摘要】The development of community health service which improves China’s medical security system and ensures the fairness and accessibility of public health service supply is an important measure. In recent years, community health service in the regions has developed rapidly, with remarkable results. Today, our country has set up 27308 community health service centers (stations). 29.5 million community health service medical staff, number of beds 101,448. Only take 2009 for example, national community health service centers provided treatment to 2.6 billion people and number of admissions 164.2 million; on average, the annual center visits 50,000 people and annual admissions 315 people; national community health service stations provided treatment to 1.2 billion people and the annual station visits per 5259 people. Community health service has become a useful tool to alleviate the phenomenon “it is difficult and expensive for people to see a doctor.”Because of community health service playing an important role in perfecting medical security system, so we need to give comprehensive evaluation of the carrying case of each community health service institutions, finding work process problems and deficiencies and making deep analysis of problem causes and summarizing the experience. Therefore, this study focuses on
the performance evaluation of community health service and divided into five parts:The first part expounds the main purpose of this study. This study establishes a set of practical and feasible community health service performance evaluation index system on the basis of the experts and scholars at home and abroad and through the investigation of each community health service institution of Shenyang Helping District.The second part describes the basic theory of the performance evaluation of community health service. Master the performance evaluation of community health services related to the basic theory is the establishment of community health service performance evaluation index system. Through the definition of the related concept, making a comprehensive understanding of the status quo at home and abroad, explicating the contents, principle and standards will provide theoretical guidance for the establishment of community health service performance evaluation system.The third part establishes community health service performance evaluation index system. This part is the core content of this study. Through the comprehensive use of literature review, field investigations and other methods, this study initially puts forward the optional index of the community health service performance evaluation index system.
On this basis, this study carries out two rounds of screening optional index by Delphi expert consultation method and determining the index weight, eventually to build a performance evaluation index system.The fourth part is the establishment of community health service performance evaluation system based on empirical research. This study makes the development situation of Shenyang Helping District community health service as the research object. According to the selected indicators, this study collects relevant data of the 2010 work situation of nine Helping District community health service center. After the inspection to the reliability and validity of the index system, through data envelopment analysis (DEA), this study carries out a comprehensive evaluation of the development situation of nine community health service center and analyzes the results. Poor community health service center will be given opinions and suggestions to improve work.The fifth is proposed to improve the performance of community health service. The countermeasures of the development of community health service: first, we must further strengthen the performance management of community health service; second, the government should give rigid assurance to the investment of community health service; the third is to establish and
improve the financing and compensation mechanism of community
health service; the fourth is to perfect community health
service function and effectively improve the community health
service quality; the fifth is to continue to strengthen talent introduction and training of community health service; the
sixth is to actively promote the community health service mechanism system innovation.
【关键词】社区卫生服务绩效评价指标体系德尔菲专家咨询
法数据包络
【采买全文】1.3.9.9.38.8.4.8 1.3.8.1.13.7.2.1 同时提供论文写作一对一辅导和论文发表服务.保过包发.
【说明】本文仅为中国学术文献总库合作提供，无涉版权。

作者如有异议请与总库或学校联系。

【英文关键词】community health service performance evaluation index system Delphi expert
consultation method DEA
【目录】社区卫生服务绩效评价研究摘要
4-6 ABSTRACT 6-7 绪论11-21 0.1 选题背景11-12 0.2
选题的意义12-13 0.3 国内外研究综述13-15 0.4 研究内容
15-17 0.5 研究方法17-19 0.6 论文创新点和不足之处
19-21 １社区卫生服务绩效评价的基本理论21-28 1.1 社区功
能理论21 1.2 公平、效率理论21-22 1.2.1 公平理论
21-22 1.2.2 效率理论22 1.3 绩效评价理论22-24 1.3.1
绩效评价22-23 1.3.2 绩效评价的意义与作用23 1.3.3 绩效评价的常用方法23-24 1.3.4 绩效评价系统的建立过程24 1.4 社区卫生服务绩效评价的内容24-25 1.5 社区卫生服务绩效评价的原则25 1.6 社区卫生服务绩效评价的分类25-26 1.7 国内外社区卫生服务绩效评价开展情况26-28 2 社区卫生服务绩效评价指标体系的构建28-41 2.1 社区卫生服务绩效评价指标体系的初步建立28-29 2.2 德尔菲法优取指标29-41 2.2.1 德尔菲法应用中的几个关键指标30-32 2.2.2 咨询专家的基本情况
32-33 2.2.3 第一轮专家咨询33-37 2.2.4 第二轮专家咨询
37-41 3 社区卫生服务绩效评价的实证分析41-55 3.1 沈阳市和平区社区卫生服务工作开展基本情况41-44 3.2 数据包络的基本简介44-45 3.2.1 数据包络的基本概念44 3.2.2 数据包络分析模型44-45 3.3 和平区2010 年度各社区卫生服务中心绩效评价45-52 3.3.1 样本分析45-49 3.3.2 社区卫生服务绩效评价指标体系的信度与效度分析49-52 3.4 结果分析52-53 3.5 结论53-55 4 改进提高社区卫生服务工作绩效的对策建议
55-59 4.1 进一步加强社区卫生服务的绩效管理55 4.2 政府对社区卫生服务投入要有刚性保证55-56 4.3 建立健全社区卫生服务的筹资与补偿机制56 4.4 完善社区卫生服务功能，有效提高社区卫生服务质量56 4.5 继续加强社区卫生服务人才引进和培
养工作56-57 4.6 积极推动社区卫生服务的机制体制创新
57-59 4.6.1 严格执行收支两条线管理制度57 4.6.2 做好社
区卫生服务工作与医疗保险制度的衔接57 4.6.3 健全完善双向有序转诊体系57 4.6.4 改革社区卫生服务投入方式
57-58 4.6.5 加快社区卫生服务机构多元化建设58-59 参考文献59-62 附录 1 62-63 附录 2 63-72 致谢72-73 攻读学位期间发表论文情况73-74。