紧密型县域医共体下广西基层医疗卫生机构服务绩效评价研究OA

Background The key and difficulty in building a compact county medical community lies in grassroots medical and health institutions.Currently,research on grassroots medical and health institutions under the compact county medical community mainly uses discontinuous time series models and DEA models to analyze their operational efficiency.There is a lack of comprehensive evaluation of the service performance of grassroots medical and health institutions from multiple dimensions,Therefore,it is of great significance to conduct research on the service performance of grassroots medical and health institutions under the tight county medical community.Objective Evaluate the service performance of grassroots medical and health institutions in 39 pilot counties(cities,districts)of Guangxi's tightly knit county-level medical communities,in order to provide a basis for deepening the high-quality development of Guangxi and nationwide tightly knit county-level medical communities.Methods Collect operational data of grassroots medical and health institutions in 39 pilot counties(cities,districts)from 2018 to 2021,and evaluate them using descriptive analysis,entropy weighted TOPSIS and RSR.Results From 2018 to 2021,the Ci values of the service performance of grassroots medical and health institutions were 0.311 2,0.363 2,0.579 1,and 0.674 2,respectively.Ranked first in 2021 and last in 2018;In 2021,a total of 7 pilot counties(cities,districts)were evaluated as"excellent"in the service performance of grassroots medical and health institutions,accounting for 17.95%.A total of 6 individuals were rated as"poor",accounting for 15.38%.The remaining 26 were rated as"medium",accounting for 66.67%.Conclusion The sinking of resources has been improved,capacity building has been further strengthened,access to health equity has increased,the efficiency of medical insurance fund utilization has improved,and overall service performance is showing an upward trend.However,the two-way referral system needs to be strengthened,resource utilization efficiency needs to be strengthened,and the benefit sharing mechanism needs to be further improved.There are significant differences in the service performance of grassroots medical and health institutions among pilot counties(cities,districts).We need to improve and leverage the role of the county-level medical community management committee,improve the annual total budget system of the medical community,establish a comprehensive benefit distribution mechanism,and focus on supporting pilot counties(cities,districts)with relatively poor economic development.