武汉市社区公共卫生服务绩效评价研究
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摘要
研究目的
社区卫生服务体系建设是城市社区建设的重要组成部分,在城市两级卫生服务体系的建设中发挥着重要作用。对社区公共卫生服务绩效进行评估,有利于发现存在的问题,为进一步完善社区卫生服务体系的建设提供政策建议。
本研究旨在通过对武汉市近三年的社区公共卫生服务投入所产生的绩效和效果进行综合性评估,全面分析社区公共卫生服务补助政策,及时总结政策落实情况及成功的经验,评估工作成效,发现存在的问题,探索解决和调整措施,为武汉市的主管部门对社区卫生服务工作的督导、考核和补助经费的管理与决策提供依据,促进建立效益良好的、可持续的长效投入机制。
研究方法
本课题采用社会学和经济学的研究原理和技术,利用文献研究和实证研究,从社区卫生服务的供方、需方两方面开展调查研究。通过查阅国内外关于社区卫生服务绩效的有关论著和文献,总结社区卫生服务绩效评价的思想和理念,为本次研究提供理论基础;通过现场调查,全面调查武汉市社区公共卫生资源配置情况、人员工作效率以及社区卫生服务的利用情况;运用SWOT分析法综合考虑社区卫生服务机构的内部条件和外部环境的各种因素,对其优势、劣势以及发展中面临的机遇和挑战进行系统评价;通过投入产出分析,分析社区卫生服务机构资源分配和使用的平衡关系;利用数据包络分析,计算社区卫生服务机构的相对效率得分,比较各个区服务的相对效率。
研究内容
本研究主要以武汉市社区公共卫生服务为评价对象,从社区卫生服务供方和需方两个方面对社区卫生服务效率进行评价,主要内容包括:(1)通过对社区卫生服务绩效评价相关理论的回顾和总结,为社区基本医疗和公共卫生服务绩效评价提供理论基础;(2)武汉市社区卫生服务中心基本情况,包括机构的性质、人员、投入、相关政策的实施、财务收支以及服务提供等情况;(3)社区卫生服务机构资源配置效率评估,分析服务数量变化、门诊及住院数量增长、公共卫生服务项目的服务类别与数量等情况,以及对社区卫生服务机构的投入所产生的效率:(4)社区卫生服务机构工作人员工作效率评价,了解各项工作时间分配,分析社区卫生服务功能的实现以及有无偏颇的情况;(5)社区卫生服务机构的社会效益评估,了解利益相关者对社区卫生服务机构的评价和看法,如居民对社区卫生服务机构的满意度与反应性,评估社区卫生服务机构的社会效益。
研究结果
通过对调查结果进行分析,得出以下研究结果:(1)武汉市社区卫生服务的网络已经基本建成,七个中心城区的社区卫生服务机构几乎覆盖了全部的地域人口,87.09%的中心其业务用房面积达到或超过国家标准;(2)截止到2007年6月30日,七个中心城区社区卫生服务中心在职在岗人员总数5535人,临床医生占在职在岗人员的28.18%,护理人员占在职在岗人员24.46%,医护比例为1:0.88;公共卫生医师占在职在岗人员的4.03%。医生学历以本科为主,护士学历以中专为主;(3)武汉市社区卫生服务中心经营状况逐步改善,2007年盈利机构占87.88%,政府财政投入逐年上升,但占中心收入的比例仍然较小(14.83%～21.4%),财政专项补助占政府投入的32%～56%,公共卫生投入是财政专项补助的主要部分,占专项补助的65.74%～70.28%,业务收入是机构收入的主要来源(占80%以上),药品收入占业务收入的比例在60%以上;(4)大部分社区卫生服务中心已开展了体现社区卫生服务功能特点的服务项目,提供量有了较大增长,2006年门诊总人次的增长率为30.45%,公共卫生服务方面,家庭档案建档数、计划生育咨询指导人次数的增长幅度较大,2006年的增长率分别为54.02%、49.12%;孕产妇系统管理人数增长率为18.81%,康复服务增长率31.52%;其他服务增长幅度较小;(5)工作人员对本职工作认可程度较高,54.14%的人员发展前景比较乐观。但是,大部分的人员(约55.32%)对目前的收入表示不满意,认为无法达到与工作量相对应的收入水平。(6)居民对基本医疗服务的知晓率较高,但对公共卫生知晓率较低。对看病的知晓度最强高,达到96.45%,居民对方便性和服务态度方面的满意度较高,但对服务价格和医疗技术水平的满意度相对较差。(7)90%以上的居民到社区卫生服务机构就诊的原因是离家近,就诊方便,而因价格适宜和候诊时间较短而就诊的居民所占比例低于35%,因医疗技术水平好就诊的比例更低,仅为8.83%。
政策建议
基于以上研究结果,本研究提出以下几点政策建议:(1)加强社区卫生服务体系建设,完善政策支持体系,确保各项配套政策落到实处;(2)进一步加大财政投入力度,拓展筹资渠道,保障基本医疗和公共卫生服务的有效开展;(3)加强社区卫生服务人才培养,强化岗位培训,提高社区卫生服务人员业务水平;(4)进一步完善社区卫生服务功能,改善服务质量和水平,提高居民对卫生服务的满意度;(5)加大社区卫生服务的宣传力度,拓宽宣传渠道
研究的创新点与今后研究方向
本研究在国内率先采用定性和定量的方法,从社区卫生服务的供方和需方两个层面,围绕社区卫生服务的支持体系、功能履行和绩效评价三各方面,联系社区公共卫生服务的实际,聚焦社区公共卫生服务的经济效益和社会效益,多角度全方位采集大量的数据,进行深入综合分析和评估,类似研究在国内鲜有报道。
本研究为社区公共卫生服务定量分析打下了良好的基础。武汉市应用该研究成果率先在国内首先试行社区公共卫生服务定量考核与经费核拨相结合的社区公共卫生服务考核办法,得到各界的普遍认可,说明该研究还具有良好的实用性。
社区公共卫生服务评价需要建立绩效评价的资料收集平台和系统,构建一个完善的信息系统,既能及时进行信息收集、分析信息,同时又满足了日常管理中监测控制、报告的需要。同时建立第三方评估机制。
当前亟待建立一整套科学完整的社区公共卫生服务综合评价体系,评价指标的筛选上,要进一步探索和实践,指标数目要精简,反映内容要比较全面,运用时方便基层,操作和计算比较简便。在评估方法上,应当采取定性与定量分析方相结合,建立评估模型,合理确定指标体系和指标的权重。
目前社区卫生服务面临的政策环境不断发生变化,运行机制、管理体制也不断创新,在选择评价指标中要能满足社区卫生服务绩效评价时间跨度的需求,如大医院托管后社区卫生服务机构的评价指标等。评价指标的变化受多种因素的影响,它会随着人们对绩效的认识的发展变化而变化,同样也会随着社区卫生事业本身的发展而变化,更重要的是评价指标要以广大群众的健康需要和服务需求为前提。本次研究结果不是研究的终点,而是下一次研究的始点,并为其他研究者提供一定的参考和借鉴。指标体系的时效性决定了该项研究的长期性。
Research Purposes
Community health services system is an important component of urban communities building,it plays an important role in the urban two-tier health services system.The performance evaluation of community basic medical and public health services can find the existing problem,and provide further policy recommendations for the development of community health services system.
In order to provide basis for government's supervision,assessment of community health services and the management of the guants,promote the establishment of good-effectives,sustainable and long-term investment mechanism,this study was aimed to use economics method to make a comprehensives assessment of investment performance and efficiency of community health services,make a comprehensive analysis on subsidy policy of community health services,sum up the implementation of ploicies and successful experience,assese the effectivess of community health services,find the existing problem and explore the solutions and adjustment measures.
Research Methods
This study adopts principle and technology of sociology and economics to make research from the supply side,demand side.Literature searching was used to summ up the ideas and concepts of commnity health services performance evaluation and provides theoretical basis for the study;field investigation was also used to survey the resource allocation,staff efficiency and the use of services in community health services institutions;SWOT analysis was used to make an systematic analysis of the internal conditions and external environment of community health services institutions;and further assess the strengths,weaknesses,opportunities and threats during the development;assessing the balance between the resource allocation and the use of services through the input-output analysis;finally,using data envelopment analysis to calculate the relative efficiency score of community health services and compare the ralstive efficiency of different district.
Research Contents
In this study,community basic medical and public health services in Wuhan City was seens as evaluation objects,and community health services was evaluated from the supply side and demand side,the main contents includs:(1) reviewing and summing up the theory of performance evaluation of community health services,and providing theoretical basis for the performance evaluation of community basic medical and public health services;(2) basic status of community health services centers in Wuhan City,including the nature of institutions,personnel,investment,the implementation of relate polices,financial,services and so on;(3) assessing the efficiency of resource allocationg in community health services institutions,analysing the change of services quantity,the growth of outpatient and residential,items and quantity of public health services,and the efficiency of investment;(4) assessing the efficiency of staff in community health services institutions,understanding the distributiong of working hours,and analysing the realization of community health services function;(5) assessing the social benefits of community health services institutions,understanding stakeholders' view on community health services,such as residents' satisfaction and responsiveness of community health services.
Research results
The results of this study are as follows:(1) the community health services network in Wuhan City has been completed,community health services institutions in seven downtown areas covered nearly all the regional population,the percentum of center whose business premises meet or exceed mational standards had reached 87.09; (2) as of Sep 30,2007,the total number of staff in community health services centers in Wuhan City was 5535,clinicians accounted for 28.18%,nurses accounted for 24.46%,public health physicians accounted for 4.03%,the ratio of clinicians to nurses was 1:0.88;(3) the operating conditions of community health services centers in Wuahan City had been gradually improved,In 2007,profit institutions accounted for 87.88%,the finacial investment increased year-by-year,but the proportion was still relatively small(14.83%～21.4%),the special subsidies in government investment accounted for 32%～56%,public health financial input was the main part of sepcial subsidies,accounting for 65.74%～70.28%,operating income was the main source of revenue,accounting for 80%or more,pharmaceuticals revenue in the ratio of operating income was more than 60%;(4) most community health services centers has launched the services which represent the characteristics of community health services function,the provision of services had a larger growth;in 2006,the growth rate of outpatient was 30.45%,in the term of public health services,the setting of family files and family planning had an large scope growth,the growth rate were 54.02%and 49.12%,the growth rate of maternal systems management was 18.81%, the growth rate of rehabilitation was 31.52%,other services had a smaller growth rate; (5) staff had an higher degree of recognition on their own work,54.14%of staff had an potimistic idea on the development of community health services institutions,but most of staff expressed dissatisfaction with the current income which can not be achieved with the workload corresponding to the level of income;(6) residents' awareness of basic medical was higher than public health services,the most high awareness is medicine which reaching 96.45%,the satisfaction with convenicence and service attitude was higher,but the satisfaction with price and technology leverl was relatively poor;(7) more than 90%of the residents choosed the community health services institutions because of the near distance and the convenience,the proportion of residents who went to community institutions because of cheaper expense and shorter waiting time was lower than 35%,the rate of good medical technology only accounted for 8.83%.
Policy suggestions
Based on the results of the research,the conclusions and recommendations could be put forward.(1) community health services system should be strengthened,the policy support system should be improved and the match policy should be carded out effectively;(2) financial input should be further increased,financing channels should be expanded and basic medical and public health services should be developed effectively;(3) community health services personnel training and job training should be strengthened,and improving the business level of staff;(4) the functions,quality and standard of community health services should be farther improved in order to improve the satisfaction of resident;(5) the publicity of community health services should be intensfied and the channels should be expanded.
社区卫生服务体系建设是城市社区建设的重要组成部分,在城市两级卫生服务体系的建设中发挥着重要作用。对社区公共卫生服务绩效进行评估,有利于发现存在的问题,为进一步完善社区卫生服务体系的建设提供政策建议。
本研究旨在通过对武汉市近三年的社区公共卫生服务投入所产生的绩效和效果进行综合性评估,全面分析社区公共卫生服务补助政策,及时总结政策落实情况及成功的经验,评估工作成效,发现存在的问题,探索解决和调整措施,为武汉市的主管部门对社区卫生服务工作的督导、考核和补助经费的管理与决策提供依据,促进建立效益良好的、可持续的长效投入机制。
研究方法
本课题采用社会学和经济学的研究原理和技术,利用文献研究和实证研究,从社区卫生服务的供方、需方两方面开展调查研究。通过查阅国内外关于社区卫生服务绩效的有关论著和文献,总结社区卫生服务绩效评价的思想和理念,为本次研究提供理论基础;通过现场调查,全面调查武汉市社区公共卫生资源配置情况、人员工作效率以及社区卫生服务的利用情况;运用SWOT分析法综合考虑社区卫生服务机构的内部条件和外部环境的各种因素,对其优势、劣势以及发展中面临的机遇和挑战进行系统评价;通过投入产出分析,分析社区卫生服务机构资源分配和使用的平衡关系;利用数据包络分析,计算社区卫生服务机构的相对效率得分,比较各个区服务的相对效率。
研究内容
本研究主要以武汉市社区公共卫生服务为评价对象,从社区卫生服务供方和需方两个方面对社区卫生服务效率进行评价,主要内容包括:(1)通过对社区卫生服务绩效评价相关理论的回顾和总结,为社区基本医疗和公共卫生服务绩效评价提供理论基础;(2)武汉市社区卫生服务中心基本情况,包括机构的性质、人员、投入、相关政策的实施、财务收支以及服务提供等情况;(3)社区卫生服务机构资源配置效率评估,分析服务数量变化、门诊及住院数量增长、公共卫生服务项目的服务类别与数量等情况,以及对社区卫生服务机构的投入所产生的效率:(4)社区卫生服务机构工作人员工作效率评价,了解各项工作时间分配,分析社区卫生服务功能的实现以及有无偏颇的情况;(5)社区卫生服务机构的社会效益评估,了解利益相关者对社区卫生服务机构的评价和看法,如居民对社区卫生服务机构的满意度与反应性,评估社区卫生服务机构的社会效益。
研究结果
通过对调查结果进行分析,得出以下研究结果:(1)武汉市社区卫生服务的网络已经基本建成,七个中心城区的社区卫生服务机构几乎覆盖了全部的地域人口,87.09%的中心其业务用房面积达到或超过国家标准;(2)截止到2007年6月30日,七个中心城区社区卫生服务中心在职在岗人员总数5535人,临床医生占在职在岗人员的28.18%,护理人员占在职在岗人员24.46%,医护比例为1:0.88;公共卫生医师占在职在岗人员的4.03%。医生学历以本科为主,护士学历以中专为主;(3)武汉市社区卫生服务中心经营状况逐步改善,2007年盈利机构占87.88%,政府财政投入逐年上升,但占中心收入的比例仍然较小(14.83%～21.4%),财政专项补助占政府投入的32%～56%,公共卫生投入是财政专项补助的主要部分,占专项补助的65.74%～70.28%,业务收入是机构收入的主要来源(占80%以上),药品收入占业务收入的比例在60%以上;(4)大部分社区卫生服务中心已开展了体现社区卫生服务功能特点的服务项目,提供量有了较大增长,2006年门诊总人次的增长率为30.45%,公共卫生服务方面,家庭档案建档数、计划生育咨询指导人次数的增长幅度较大,2006年的增长率分别为54.02%、49.12%;孕产妇系统管理人数增长率为18.81%,康复服务增长率31.52%;其他服务增长幅度较小;(5)工作人员对本职工作认可程度较高,54.14%的人员发展前景比较乐观。但是,大部分的人员(约55.32%)对目前的收入表示不满意,认为无法达到与工作量相对应的收入水平。(6)居民对基本医疗服务的知晓率较高,但对公共卫生知晓率较低。对看病的知晓度最强高,达到96.45%,居民对方便性和服务态度方面的满意度较高,但对服务价格和医疗技术水平的满意度相对较差。(7)90%以上的居民到社区卫生服务机构就诊的原因是离家近,就诊方便,而因价格适宜和候诊时间较短而就诊的居民所占比例低于35%,因医疗技术水平好就诊的比例更低,仅为8.83%。
政策建议
基于以上研究结果,本研究提出以下几点政策建议:(1)加强社区卫生服务体系建设,完善政策支持体系,确保各项配套政策落到实处;(2)进一步加大财政投入力度,拓展筹资渠道,保障基本医疗和公共卫生服务的有效开展;(3)加强社区卫生服务人才培养,强化岗位培训,提高社区卫生服务人员业务水平;(4)进一步完善社区卫生服务功能,改善服务质量和水平,提高居民对卫生服务的满意度;(5)加大社区卫生服务的宣传力度,拓宽宣传渠道
研究的创新点与今后研究方向
本研究在国内率先采用定性和定量的方法,从社区卫生服务的供方和需方两个层面,围绕社区卫生服务的支持体系、功能履行和绩效评价三各方面,联系社区公共卫生服务的实际,聚焦社区公共卫生服务的经济效益和社会效益,多角度全方位采集大量的数据,进行深入综合分析和评估,类似研究在国内鲜有报道。
本研究为社区公共卫生服务定量分析打下了良好的基础。武汉市应用该研究成果率先在国内首先试行社区公共卫生服务定量考核与经费核拨相结合的社区公共卫生服务考核办法,得到各界的普遍认可,说明该研究还具有良好的实用性。
社区公共卫生服务评价需要建立绩效评价的资料收集平台和系统,构建一个完善的信息系统,既能及时进行信息收集、分析信息,同时又满足了日常管理中监测控制、报告的需要。同时建立第三方评估机制。
当前亟待建立一整套科学完整的社区公共卫生服务综合评价体系,评价指标的筛选上,要进一步探索和实践,指标数目要精简,反映内容要比较全面,运用时方便基层,操作和计算比较简便。在评估方法上,应当采取定性与定量分析方相结合,建立评估模型,合理确定指标体系和指标的权重。
目前社区卫生服务面临的政策环境不断发生变化,运行机制、管理体制也不断创新,在选择评价指标中要能满足社区卫生服务绩效评价时间跨度的需求,如大医院托管后社区卫生服务机构的评价指标等。评价指标的变化受多种因素的影响,它会随着人们对绩效的认识的发展变化而变化,同样也会随着社区卫生事业本身的发展而变化,更重要的是评价指标要以广大群众的健康需要和服务需求为前提。本次研究结果不是研究的终点,而是下一次研究的始点,并为其他研究者提供一定的参考和借鉴。指标体系的时效性决定了该项研究的长期性。
Research Purposes
Community health services system is an important component of urban communities building,it plays an important role in the urban two-tier health services system.The performance evaluation of community basic medical and public health services can find the existing problem,and provide further policy recommendations for the development of community health services system.
In order to provide basis for government's supervision,assessment of community health services and the management of the guants,promote the establishment of good-effectives,sustainable and long-term investment mechanism,this study was aimed to use economics method to make a comprehensives assessment of investment performance and efficiency of community health services,make a comprehensive analysis on subsidy policy of community health services,sum up the implementation of ploicies and successful experience,assese the effectivess of community health services,find the existing problem and explore the solutions and adjustment measures.
Research Methods
This study adopts principle and technology of sociology and economics to make research from the supply side,demand side.Literature searching was used to summ up the ideas and concepts of commnity health services performance evaluation and provides theoretical basis for the study;field investigation was also used to survey the resource allocation,staff efficiency and the use of services in community health services institutions;SWOT analysis was used to make an systematic analysis of the internal conditions and external environment of community health services institutions;and further assess the strengths,weaknesses,opportunities and threats during the development;assessing the balance between the resource allocation and the use of services through the input-output analysis;finally,using data envelopment analysis to calculate the relative efficiency score of community health services and compare the ralstive efficiency of different district.
Research Contents
In this study,community basic medical and public health services in Wuhan City was seens as evaluation objects,and community health services was evaluated from the supply side and demand side,the main contents includs:(1) reviewing and summing up the theory of performance evaluation of community health services,and providing theoretical basis for the performance evaluation of community basic medical and public health services;(2) basic status of community health services centers in Wuhan City,including the nature of institutions,personnel,investment,the implementation of relate polices,financial,services and so on;(3) assessing the efficiency of resource allocationg in community health services institutions,analysing the change of services quantity,the growth of outpatient and residential,items and quantity of public health services,and the efficiency of investment;(4) assessing the efficiency of staff in community health services institutions,understanding the distributiong of working hours,and analysing the realization of community health services function;(5) assessing the social benefits of community health services institutions,understanding stakeholders' view on community health services,such as residents' satisfaction and responsiveness of community health services.
Research results
The results of this study are as follows:(1) the community health services network in Wuhan City has been completed,community health services institutions in seven downtown areas covered nearly all the regional population,the percentum of center whose business premises meet or exceed mational standards had reached 87.09; (2) as of Sep 30,2007,the total number of staff in community health services centers in Wuhan City was 5535,clinicians accounted for 28.18%,nurses accounted for 24.46%,public health physicians accounted for 4.03%,the ratio of clinicians to nurses was 1:0.88;(3) the operating conditions of community health services centers in Wuahan City had been gradually improved,In 2007,profit institutions accounted for 87.88%,the finacial investment increased year-by-year,but the proportion was still relatively small(14.83%～21.4%),the special subsidies in government investment accounted for 32%～56%,public health financial input was the main part of sepcial subsidies,accounting for 65.74%～70.28%,operating income was the main source of revenue,accounting for 80%or more,pharmaceuticals revenue in the ratio of operating income was more than 60%;(4) most community health services centers has launched the services which represent the characteristics of community health services function,the provision of services had a larger growth;in 2006,the growth rate of outpatient was 30.45%,in the term of public health services,the setting of family files and family planning had an large scope growth,the growth rate were 54.02%and 49.12%,the growth rate of maternal systems management was 18.81%, the growth rate of rehabilitation was 31.52%,other services had a smaller growth rate; (5) staff had an higher degree of recognition on their own work,54.14%of staff had an potimistic idea on the development of community health services institutions,but most of staff expressed dissatisfaction with the current income which can not be achieved with the workload corresponding to the level of income;(6) residents' awareness of basic medical was higher than public health services,the most high awareness is medicine which reaching 96.45%,the satisfaction with convenicence and service attitude was higher,but the satisfaction with price and technology leverl was relatively poor;(7) more than 90%of the residents choosed the community health services institutions because of the near distance and the convenience,the proportion of residents who went to community institutions because of cheaper expense and shorter waiting time was lower than 35%,the rate of good medical technology only accounted for 8.83%.
Policy suggestions
Based on the results of the research,the conclusions and recommendations could be put forward.(1) community health services system should be strengthened,the policy support system should be improved and the match policy should be carded out effectively;(2) financial input should be further increased,financing channels should be expanded and basic medical and public health services should be developed effectively;(3) community health services personnel training and job training should be strengthened,and improving the business level of staff;(4) the functions,quality and standard of community health services should be farther improved in order to improve the satisfaction of resident;(5) the publicity of community health services should be intensfied and the channels should be expanded.
引文
1.国务院.中共中央关于卫生改革与发展的决定.1997
2.卫生部等十部委.关于发展城市社区卫生服务的若干意见.1999
3.卫生部等十一部委.关于加快发展城市社区卫生服务的意见,2002
4.国务院.国务院关于发展城市社区卫生服务的指导意见.2006
5.世界卫生组织.2000年世界卫生报告.北京,人民卫生出版社,2001
6.第五次全国人口普查报告
7.章单单,涂荣军.城市社区卫生服务运行机制研究.卫生经济研究,2006,(9):35
8.http://www,moh.gov.cn/open/statistics/year2006/p85,htm
9.李长明,姚建红.大力推进医疗卫生体制改革,加快发展社区卫生服务.中华医院管理杂志,2003,19(2):65-69
10.饶克勤,尹力,刘远立.中国居民健康转型、卫生服务需求变化及其对经济、社会发展的影响之二.中国卫生经济,2000,19(10):8-11.
11.论社区卫生服务的定位与发展.《中国全科医学》
12.杨学来,徐凌中,孙胤羚.我国社会卫生服务体系改革研究.中国卫生事业管理,2006,(4):204
13.孙丽颖,樊立华,李侠.社区卫生服务纳入基本医疗保险服务项目的界定[J].中国初级卫生保健,2003,17(2):25-26.
14.鲍勇主编:《社区卫生服务实用指南》,上海科学技术出版社
15.龚向光.从公共卫生内涵看我国公共卫生走向[J].卫生经济研究,2003,9:6-10
16.Institute of Medicine.The future of public health National Academy Press,Washington Dc.1988.
17.Last JM.Dictionary of Epidemiology Oxford University Press 1995.
18.Institute of Medicine.The future of the public's health in 21st century.The National Academies Press,Washington Dc.2003.
19.李惠娟、季正明主编:《社区卫生服务实用手册》,复旦大学出版社,2002年 10月第1版
20.徐荣佳,介评.分析卫生保健可持续发展能力的方案.国外医学.医院管理分册,2000,2:80-82.
21.McMichael AJ.Population health as the 'bottom line' of sustainability:a contemporary challenge for public health researchers.Eur J Public Health.2006Dec;16(6):579-81.Epub 2006 Jul 19..
22.张祖芸,李琳,沈建华等.卫生系统绩效的评价责任和策略.中国卫生政策,2002,(3):27-28
23.Richard Long.Tuberculosis control in Alberta:A'federal,provincial and regional public health partnership.Canadian Journal of public Health.Ottawa:Jul/Aug 2002.932002.93(4)..
24.Stephen H Linder.On the politics of policy development.Journal of Public Health Management and Practice.Frederick:Jan 2002,8(1):62.
25.Handler AS,A conceptual Framework to measure Performance of the Public Health System,AJPH,2001,91(8):1235-1239.
26.汪云,陈霞等.社区卫生服务系统绩效评价框架构建.医学与社会.2008(2):19-30.
27.Musgrove P.Judging health systems:reflections on WHO's methods.Lancet.2003,24;361(9371):1817-20.
28.Aday,L.A.et al.Evaluating the Medical Care System:Effectiveness,Efficiency,and Equity.Health Administration Press,University of Michigan(Ann Arbor,MI),1993
29.World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150~
30.焦柯闻.政府投入的绩效评估.行政事业财务,2000,(5):63
31.周志忍.当代国外行政改革研究.北京:国家行政学院出版社,1999,59
32.Rutz W.The European WHO mental health programme and the World Health Report.2001:input and implications.Br J Psychiatry.2003 Jul;183:73-4
33.任苒.卫生系统绩效评估及其思考.医学与哲学,2001,22(4):19-21
34.梁万年.社区卫生服务管理[M].北京:人民卫生出版社,2001:260-284.
35.王虹,杨兴华,粱万年.社区卫生服务模式效果效益评价指标体系信度、效度的初步研究.中华医院管理杂志,2003,19(8):651-652
36.梁万年,王红,杨兴华.中国城市社区卫生服务评价指标体系的建立.中国卫生事业管理,2002,8:460-462
37.郭清,汪胜,王小合.中国城市社区卫生服务评价指标研究.中国全科医学,2002,5(11):887-888
38.郭清,汪胜,王小合.2005年城市社区卫生服务发展目标评价方案的初步研究.中国初级卫生保健,2002,16(8):4-5
39.龚幼龙,李鲁.社会医学[M].北京:人民卫生出版社,2003:15-30.
40.周俊安.深圳市社区卫生服务绩效评价概述[J].中国全科医学,2005,8:356-358.
41.裴丽昆.澳大利亚卫生系统绩效评价框架[J].中华医院管理,2004,20:510-512.
42.武汉市卫生局.推进基本医疗保障进社区文件汇编(一)2005.3
43.武汉市卫生局.推进基本医疗保障进社区文件汇编(二)2006.3
44.鲍勇.社区卫生服务中社区诊断与健康档案管理工作的完善[J]中国全科医学.2005,8:1461-1463.
45.赵志广.深圳市流动人口卫生服务需求和利用研究.华中科技大学通济医学院博士论文集.2005
46.Christinsen T.A.SWOT analysis of the organization and financing of the Danish health care system.Health Policy,2002,59(2):99-106[EB/OL].http://www.gov.cn/node_10720/content_229454_2.htm,2006,02,24.
47.梁万年,王亚东,杨兴华等.全国社区卫生服务现状调查.中国全科医学,2005,8(9):705
48.Chrstopher JL Murray and Julio Frenk.A WHO Framework for Health System Performance Assessment.Geneva,World Health Organization,1999(Global Programme on Evidence for Health Policy Discussion Paper No.6)
49.World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150.
50.Schlagenhauf P.SARS in hiding:WHO calls for vigilance.Lancet Infect Dis.2003,3(8):458
51.Basu P.SARS-struck nations step up surveillance efforts.Nat Med.2003,9(7):806
52.Cyranoski D.WHO issues rallying cry to keep fight against SARS on track.Nature.2003,424(6943):905-6
53.鲍勇.社区卫生服务项目流程化管理研究(二)--制定基本社区卫生服务项目[J].中国全科医学,2005,8:353-355.
54.张泽,祁素文.国外社区卫生服务现状及启示[J].中国全科医学,2005,8:1283-1284.
55.Sitzia,J.& Wood,N.Patient Satisfaction:A Review of issues and concepts.Social Science and Medicine,1997,45(12):1829-1843
56.Chrr-Hill,R.A.The measurement of Patient Satisfaction.Journal of Public Health Medicine,1992,13(3):236-249
57.Price M.The consequences of health service privatisation for equality and equity in health care in South Africa.Soc Sci Med.1988,27(7):703-16.
58.李曼春,吴秀云,李青晶等.社区卫生服务工作效率研究.中华医院管理杂志,2000,16(7):416-417
59.陈晓冬,陈晓玲,郭希风等.3种医院综合评价方法的比较分析.中国医院统计2001,8(2):67-70
60.李贤相,洪倩.卫生综合评价方法研究进展.实用预防医学,2003,10(6):1035-1038
61.Judith A.Hall,Michael c.Doman.Meta-analysis of satisfaction with medical care:Description of research domain and analysis of overall satisfaction levels[J].Soc Sci Med,1988,27(6):637-644.
62.Valentine N.De Silva A&Murray CJL.Estimating responsiveness level and distribution for 191 countries:methods and results.GPE Discussion Paper No.22.Geneva,WHO,2000.
63.Charles Darby,Nicole Valentine,Christopher JL Murray et al.Strategy on Measuring Responsiveness.Geneva:World Health Organization,1999(Global Programme on Evidence for Health Policy Discussion Paper No.23)
64.柳竹尧.社区医疗卫生服务可持续性发展影响因素及对策.青岛医药卫生,2005,1:33-34.
65.尹文强,傅华,安妮等.我国社区卫生服务发展阶段分析及可持续发展策略研究.中华医院管理杂志,2004,3:141-145.
66.徐艳华,杜亚平.变政府投入为政府购买--论社区卫生服务的可持续发展.全科医学临床与教育,2006,2:148-150.
67.姚岚,陈启鸿.社区卫生服务纳入基本医疗保险的政策研究概述[J].中华医院管理杂志,2002,18(1):26-28.
68.沈慰如.对政府购买社区公共卫生产品的设想[J].卫生经济研究,2004,(9):15-16.
69.Tomoda W.Primary care design:health promotion centers--a new model for healthcare delivery.J Healthc Des.1996,8:31-3.
70.Schlesinger M,Mitchell S,Gray B.Measudng community benefits provided by nonprofit and for-profit HMOs.Inquiry.2003,40(2):114-32.
71.王小丽.社区卫生服务的经济学思考.中国卫生经济,2000,19(209):28-29
72.尹文强,傅华等.社区卫生服务机构的SWOT分析[J].中华医院管理杂志,2004;20(3):138-141.
73.樊立华,孙涛等.不同举办主题开展社区卫生服务的SWOT分析[J].中国农村卫生事业管理,2007,27(2):107-108.
[1]世界卫生组织2000年世界卫生报告--卫生系统:发展进程.北京:人民卫生出版社,2000
[2]Mare J.Roberts,Williams Hsiao,Peter Berman,etal.Getting Health Reform Right,Background Material for Flagship Course on Health Reform and Sustantinable Financing,World Sank,Washington,2001
[3]World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150
[4]宋文虎,张正华.2000年世界卫生报告给我们的启示,中华医院管理杂志,2001,5(17):263-265
[5]张祖云,李琳,沈建华等.卫生系统绩效的评价责任和策略.中国卫生政策,2002,(3):27-28
[6]罗伯特.巴克沃.绩效管理.北京:中国标准出版社,科文出版有限公司,2002
[7]Sim F,Mackie P.Health impact assessment--a science and art for public health.Public Health.2003,i17(5):293-4.
[8]卫生部等十部委.关于发展城市社区卫生服务的若干意见.1999,7
[9]MURRYCJL.Overall health system achievement for 191 countries.World Health Organization,2000,Discussion Paper.
[10]Kleinman A.Concepts and a model for the comparison of medical dsystems as cultural systems.Social Science and Medicine,1978,12:85-93.
[11]Murray CJL,Frenk J.A WHO framework for health system performance assessment.Geneva,World Health Organizationa,1999(GPE Discussion Paper NO.6).
[12]马进,孔巍等.我国卫生服务系统绩效分析.中国卫生经济.2003,12(12):7-9.
[13]Claes Enoe,M P.Georgiadis,Wesley OJ.Estimation of sensitivity and specificity of diagnostic tests and diseases prevalence when the diseasestateisunknown.Preventiveveterinarymedicine,2000,45:61-81.
[14]Claes Enoe,Soren Andersen,Vibeke Sorensen,et al.Estimation of sensitivity,specificity and predictive values of two serologic tests for the detection of antibodies against Actinobacillus pleuropneumoniae serotype in the absence of areference test(Gold standard).Preventive veterinary Medicine,2001,51:227-243.
[15]杨文秀,杜亚平.社区卫生服务[M].北京:高等教育出版社,2003.131-133.
[16]Leiyu Shi,Barbara Starfield.Primary Care Quality:Community Health Center and Health Maintenance Organization[J].Southern Medical Journal,2003.
[17]Lou Ann Hartley.Using the primary care assessment survey in an ambulatory setting[J].Nursing Economics,2002.
[18]刘运国,张亮,等.初级卫生保健机构绩效评价[M].北京:中国财政经济出版社,2007.
[19]Taylor RB.Family medicine:curent issues and future practice.In:RB Taylor ed.Family Medicine-Principles and Practice[J].New York:Springer,1998,1-5.
[20]梁万年,王红,杨兴华.中国城市社区卫生服务评价指标体系的建立.中国卫生事业管理,2002,8:460-462
[21]郭清,汪胜,王小合.中国城市社区卫生服务评价指标研究.中国全科医学,2002,5(11):887-888
[22]郭清,汪胜,王小合.2005年城市社区卫生服务发展目标评价方案的初步研究.中国初级卫生保健,2002,16(8):4-5
[23]孙晓明,梁鸿.从四维空间看社区卫生服务发展.中国卫生事业政策,2003,(1):24-26
[24]刘杭生,彭巨亚,吴耀宪等.保定市城市居民健康状况及卫生服务利用分析. 中国全科医学,2002,5(6):460-462
[25]刘艳,吴群鸿.哈尔滨市社区卫生服务需求、利用及影响因素分析.医学与社会,2002,15(1):11-13
[26]施学忠,谢婧,贾松树等.河南省卫生系统反应性模糊综合评价.中国卫生统计,2002,19(2):99-101
[27]Musgrove P.Judging health systems:reflections on WHO' s methods.Lancet.2003,24:1817-20
[28]Brundtland GH,Frenk J,Murray CJ.Who assessment of health systems performance.Lancet.
[29]World health organization,the world health report 2000:health systenm:improving performance printed in France,2000.144-150
[30]Po AL.The British National Health Service(NHS)celebrates its 50 th anniversary:equity in a competitive world.J Clin Pharm Ther 1998,23(4):241-2
[31]Dicks L.Breaking through to improved community health.Mich Health Hosp.2003,39(4):59-62
[32]Telfair J.An evaluation of state perinatal community-based programs in Alabama:overview.Public Health Rep.2003,118(5):484-6
[33]Eaves D.An evamination of the concept equity and the implications for health policy if equity is' re-asserted as one of the key govemment objectives for the National Health Service.J Nurs Manag.1998,6(4):215-21
[34]Paul F.Hogan,et al.Physical medicine and rehabilitation workforce study:the supply of and demand for physiatrists.Arcg Phys Med Rehabil,1996
[35]Calnan M,Almond S,Smith N.s.Ageing and public satisfaction with the health service an analysis of recent trends.Soc Sci Med.2003,57(4):575-62
[36]Roberts E.Consumer satisfaction in the Health Service:the orle of the Community Health Council. The current role: its scope and limitations. R Soc Health J . 1978,98(4):173-6
[37]Stanton P. Commpetitive health policies and community health. Soc Sci Med. 2001, 52(5): 671-9
[38]Waitzkin H. Connunity-based health care: contradictions and challenges. Ann Intern Med. 1983,98(2) :235-42
[39]Kunkel S. Assessing community needs. Issue Brief Cent Medicare Educ.2003;4(5):1-6
[40]Palmer GR. Evidence-based health policy-making, hospital funding and health insurance. Med J Aust, 2000,7;172(3):130-3
[41]Cashman SB, Bushnell FK, Fulmer HS. Community-oriented primary care: a model for public health nursing. J Health Polit Policy Law. 2001, 26(3): 617-34
[42]Aday L. A., Andersen R. M. A framework for the study of access to medical care. Health Services Research, 1974, 9:208
[43]Srinivasan S, O' Fallon LR, Dearry A. Creating healthy communities, healthy homes, healthy people:initiating a research agenda on the built environment and public health. Am J Public Health. 2003, 93(9):1446-50
[44]Kuller LH. On reconsidering community-based health promotion Am J Public Health. 2003, 93(8):1201;author reply 1201-2
[45]Brommels M, Jaaskelainen M. Measures of epuity and efficiency in medical manpower planning. A prediction of internists needed in the Finnish national health service. Health Policy. 1984, 4(1):3—11
[46]Birch S, Maynard A. Regional distribution of epuity in the National Health Service.Public Health. 1978, 92(4):190-6
[47]Ashton JR. R. A. W. P. The achievement of equity in the National Health Service. Public Health. 1978, 92(4):190-6
[48]Eaves D. An examination of the concept of equity and the inplications for health policy if equity is re-asserted as one of the key government objectives for the National Health Service. J Nurs-Manag. 1998, 6(4):215-21
[49]Price M. The consequences of health service privatisation for equality and equity in health care in South Africa. Sci Med. 1988, 27 (7): 703-16
[50]Tomoda W. Primary care design: health promotion centers—a new model for healthcare delivery.J Healthc Des. 1996,8:31-3
[51]Schlesinger M, Mitchell S, Gray B. Measuring community benefits provided by nonprofit and for-profit HMOs. Inquiry. 2003, 40(2): 114-32
[52]Oswald N.Access to what?Health care for whom? Health PAC Bull. 1992, 22(1): 28-30
[53]Abby Ghobadian, et al. 1994, Service Quality Concepts and Models. International Journal of Quality&Reliability Management, 11(9):43-46
[54]Judith A. Hall, Michael c. Doman. Meta-analysis of satisfaction with medical care: Description of research domain and analysis of overall satisfaction levels[J]. Soc Sci Med, 1988, 27(6):637-644
[55]Valentine N. De Silva A&Murray CJL. Estimating responsiveness level and distribution for 191 countries:methods and results. GPE Discussion Paper No. 22. Geneva, WHO, 2000
[56]Beauchesne MA, Meservey PM. An interdisciplinary community-based educational model. J Prof Nurs. 1999,15(1):38-43
[57] MacLean JR, Zon L. A healthy community through health system partnerships:the approach of Markham Stouffville HospitaL Healthc Pap. 2000, 1(2):96-103;discussion 104-7
[58] Janie Percy-Smith. Introduction: Assessing Needs Theory and Practice. In Janie Percy-Smith. Nurs. 1999, 15(1):38-43
[59]R. Sauerbom, A. Nougtara, H. J. Diesfeld. Low utilization of community health workers: Results from a household interview survey in Burkinga Faso[J].Soc Sci Med, 1989, 29(10): 1163-1174
[60]Surpin J. Hospitals and community health centers. Health Syst Rev. 1993, 26(1): 28-31
[61]Sheman,HD. Hospital efficiency measurement and evaluation. Medical Care,1984,10:022-935
[62]Hussey T. (1997)Efficiency and health. Nursing Ethics, 1997,3:181-190
[63]Taylor SA. Distinguishing service quality from patient satisfaction in developing health care marketing strategies. Hosp Health Serv Adm. 1994, 39 (2): 221-36
[64]Baker TL, Taylor SA. Patient satisfaction and service quality in the formation of customers' future purchase intentions in competitive health service settings. Health Mark Q 1997;15(1):1-15
[65]C. Darby, N. Valentine,C.JL Murray, at el. Strategy on measuring responsiveness. GPE Discussion Paper Series:No. 23, Geneva, WHO, 2001.1
2.卫生部等十部委.关于发展城市社区卫生服务的若干意见.1999
3.卫生部等十一部委.关于加快发展城市社区卫生服务的意见,2002
4.国务院.国务院关于发展城市社区卫生服务的指导意见.2006
5.世界卫生组织.2000年世界卫生报告.北京,人民卫生出版社,2001
6.第五次全国人口普查报告
7.章单单,涂荣军.城市社区卫生服务运行机制研究.卫生经济研究,2006,(9):35
8.http://www,moh.gov.cn/open/statistics/year2006/p85,htm
9.李长明,姚建红.大力推进医疗卫生体制改革,加快发展社区卫生服务.中华医院管理杂志,2003,19(2):65-69
10.饶克勤,尹力,刘远立.中国居民健康转型、卫生服务需求变化及其对经济、社会发展的影响之二.中国卫生经济,2000,19(10):8-11.
11.论社区卫生服务的定位与发展.《中国全科医学》
12.杨学来,徐凌中,孙胤羚.我国社会卫生服务体系改革研究.中国卫生事业管理,2006,(4):204
13.孙丽颖,樊立华,李侠.社区卫生服务纳入基本医疗保险服务项目的界定[J].中国初级卫生保健,2003,17(2):25-26.
14.鲍勇主编:《社区卫生服务实用指南》,上海科学技术出版社
15.龚向光.从公共卫生内涵看我国公共卫生走向[J].卫生经济研究,2003,9:6-10
16.Institute of Medicine.The future of public health National Academy Press,Washington Dc.1988.
17.Last JM.Dictionary of Epidemiology Oxford University Press 1995.
18.Institute of Medicine.The future of the public's health in 21st century.The National Academies Press,Washington Dc.2003.
19.李惠娟、季正明主编:《社区卫生服务实用手册》,复旦大学出版社,2002年 10月第1版
20.徐荣佳,介评.分析卫生保健可持续发展能力的方案.国外医学.医院管理分册,2000,2:80-82.
21.McMichael AJ.Population health as the 'bottom line' of sustainability:a contemporary challenge for public health researchers.Eur J Public Health.2006Dec;16(6):579-81.Epub 2006 Jul 19..
22.张祖芸,李琳,沈建华等.卫生系统绩效的评价责任和策略.中国卫生政策,2002,(3):27-28
23.Richard Long.Tuberculosis control in Alberta:A'federal,provincial and regional public health partnership.Canadian Journal of public Health.Ottawa:Jul/Aug 2002.932002.93(4)..
24.Stephen H Linder.On the politics of policy development.Journal of Public Health Management and Practice.Frederick:Jan 2002,8(1):62.
25.Handler AS,A conceptual Framework to measure Performance of the Public Health System,AJPH,2001,91(8):1235-1239.
26.汪云,陈霞等.社区卫生服务系统绩效评价框架构建.医学与社会.2008(2):19-30.
27.Musgrove P.Judging health systems:reflections on WHO's methods.Lancet.2003,24;361(9371):1817-20.
28.Aday,L.A.et al.Evaluating the Medical Care System:Effectiveness,Efficiency,and Equity.Health Administration Press,University of Michigan(Ann Arbor,MI),1993
29.World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150~
30.焦柯闻.政府投入的绩效评估.行政事业财务,2000,(5):63
31.周志忍.当代国外行政改革研究.北京:国家行政学院出版社,1999,59
32.Rutz W.The European WHO mental health programme and the World Health Report.2001:input and implications.Br J Psychiatry.2003 Jul;183:73-4
33.任苒.卫生系统绩效评估及其思考.医学与哲学,2001,22(4):19-21
34.梁万年.社区卫生服务管理[M].北京:人民卫生出版社,2001:260-284.
35.王虹,杨兴华,粱万年.社区卫生服务模式效果效益评价指标体系信度、效度的初步研究.中华医院管理杂志,2003,19(8):651-652
36.梁万年,王红,杨兴华.中国城市社区卫生服务评价指标体系的建立.中国卫生事业管理,2002,8:460-462
37.郭清,汪胜,王小合.中国城市社区卫生服务评价指标研究.中国全科医学,2002,5(11):887-888
38.郭清,汪胜,王小合.2005年城市社区卫生服务发展目标评价方案的初步研究.中国初级卫生保健,2002,16(8):4-5
39.龚幼龙,李鲁.社会医学[M].北京:人民卫生出版社,2003:15-30.
40.周俊安.深圳市社区卫生服务绩效评价概述[J].中国全科医学,2005,8:356-358.
41.裴丽昆.澳大利亚卫生系统绩效评价框架[J].中华医院管理,2004,20:510-512.
42.武汉市卫生局.推进基本医疗保障进社区文件汇编(一)2005.3
43.武汉市卫生局.推进基本医疗保障进社区文件汇编(二)2006.3
44.鲍勇.社区卫生服务中社区诊断与健康档案管理工作的完善[J]中国全科医学.2005,8:1461-1463.
45.赵志广.深圳市流动人口卫生服务需求和利用研究.华中科技大学通济医学院博士论文集.2005
46.Christinsen T.A.SWOT analysis of the organization and financing of the Danish health care system.Health Policy,2002,59(2):99-106[EB/OL].http://www.gov.cn/node_10720/content_229454_2.htm,2006,02,24.
47.梁万年,王亚东,杨兴华等.全国社区卫生服务现状调查.中国全科医学,2005,8(9):705
48.Chrstopher JL Murray and Julio Frenk.A WHO Framework for Health System Performance Assessment.Geneva,World Health Organization,1999(Global Programme on Evidence for Health Policy Discussion Paper No.6)
49.World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150.
50.Schlagenhauf P.SARS in hiding:WHO calls for vigilance.Lancet Infect Dis.2003,3(8):458
51.Basu P.SARS-struck nations step up surveillance efforts.Nat Med.2003,9(7):806
52.Cyranoski D.WHO issues rallying cry to keep fight against SARS on track.Nature.2003,424(6943):905-6
53.鲍勇.社区卫生服务项目流程化管理研究(二)--制定基本社区卫生服务项目[J].中国全科医学,2005,8:353-355.
54.张泽,祁素文.国外社区卫生服务现状及启示[J].中国全科医学,2005,8:1283-1284.
55.Sitzia,J.& Wood,N.Patient Satisfaction:A Review of issues and concepts.Social Science and Medicine,1997,45(12):1829-1843
56.Chrr-Hill,R.A.The measurement of Patient Satisfaction.Journal of Public Health Medicine,1992,13(3):236-249
57.Price M.The consequences of health service privatisation for equality and equity in health care in South Africa.Soc Sci Med.1988,27(7):703-16.
58.李曼春,吴秀云,李青晶等.社区卫生服务工作效率研究.中华医院管理杂志,2000,16(7):416-417
59.陈晓冬,陈晓玲,郭希风等.3种医院综合评价方法的比较分析.中国医院统计2001,8(2):67-70
60.李贤相,洪倩.卫生综合评价方法研究进展.实用预防医学,2003,10(6):1035-1038
61.Judith A.Hall,Michael c.Doman.Meta-analysis of satisfaction with medical care:Description of research domain and analysis of overall satisfaction levels[J].Soc Sci Med,1988,27(6):637-644.
62.Valentine N.De Silva A&Murray CJL.Estimating responsiveness level and distribution for 191 countries:methods and results.GPE Discussion Paper No.22.Geneva,WHO,2000.
63.Charles Darby,Nicole Valentine,Christopher JL Murray et al.Strategy on Measuring Responsiveness.Geneva:World Health Organization,1999(Global Programme on Evidence for Health Policy Discussion Paper No.23)
64.柳竹尧.社区医疗卫生服务可持续性发展影响因素及对策.青岛医药卫生,2005,1:33-34.
65.尹文强,傅华,安妮等.我国社区卫生服务发展阶段分析及可持续发展策略研究.中华医院管理杂志,2004,3:141-145.
66.徐艳华,杜亚平.变政府投入为政府购买--论社区卫生服务的可持续发展.全科医学临床与教育,2006,2:148-150.
67.姚岚,陈启鸿.社区卫生服务纳入基本医疗保险的政策研究概述[J].中华医院管理杂志,2002,18(1):26-28.
68.沈慰如.对政府购买社区公共卫生产品的设想[J].卫生经济研究,2004,(9):15-16.
69.Tomoda W.Primary care design:health promotion centers--a new model for healthcare delivery.J Healthc Des.1996,8:31-3.
70.Schlesinger M,Mitchell S,Gray B.Measudng community benefits provided by nonprofit and for-profit HMOs.Inquiry.2003,40(2):114-32.
71.王小丽.社区卫生服务的经济学思考.中国卫生经济,2000,19(209):28-29
72.尹文强,傅华等.社区卫生服务机构的SWOT分析[J].中华医院管理杂志,2004;20(3):138-141.
73.樊立华,孙涛等.不同举办主题开展社区卫生服务的SWOT分析[J].中国农村卫生事业管理,2007,27(2):107-108.
[1]世界卫生组织2000年世界卫生报告--卫生系统:发展进程.北京:人民卫生出版社,2000
[2]Mare J.Roberts,Williams Hsiao,Peter Berman,etal.Getting Health Reform Right,Background Material for Flagship Course on Health Reform and Sustantinable Financing,World Sank,Washington,2001
[3]World health organization.the world health report 2000:health system:improving performance printed in france,2000.144-150
[4]宋文虎,张正华.2000年世界卫生报告给我们的启示,中华医院管理杂志,2001,5(17):263-265
[5]张祖云,李琳,沈建华等.卫生系统绩效的评价责任和策略.中国卫生政策,2002,(3):27-28
[6]罗伯特.巴克沃.绩效管理.北京:中国标准出版社,科文出版有限公司,2002
[7]Sim F,Mackie P.Health impact assessment--a science and art for public health.Public Health.2003,i17(5):293-4.
[8]卫生部等十部委.关于发展城市社区卫生服务的若干意见.1999,7
[9]MURRYCJL.Overall health system achievement for 191 countries.World Health Organization,2000,Discussion Paper.
[10]Kleinman A.Concepts and a model for the comparison of medical dsystems as cultural systems.Social Science and Medicine,1978,12:85-93.
[11]Murray CJL,Frenk J.A WHO framework for health system performance assessment.Geneva,World Health Organizationa,1999(GPE Discussion Paper NO.6).
[12]马进,孔巍等.我国卫生服务系统绩效分析.中国卫生经济.2003,12(12):7-9.
[13]Claes Enoe,M P.Georgiadis,Wesley OJ.Estimation of sensitivity and specificity of diagnostic tests and diseases prevalence when the diseasestateisunknown.Preventiveveterinarymedicine,2000,45:61-81.
[14]Claes Enoe,Soren Andersen,Vibeke Sorensen,et al.Estimation of sensitivity,specificity and predictive values of two serologic tests for the detection of antibodies against Actinobacillus pleuropneumoniae serotype in the absence of areference test(Gold standard).Preventive veterinary Medicine,2001,51:227-243.
[15]杨文秀,杜亚平.社区卫生服务[M].北京:高等教育出版社,2003.131-133.
[16]Leiyu Shi,Barbara Starfield.Primary Care Quality:Community Health Center and Health Maintenance Organization[J].Southern Medical Journal,2003.
[17]Lou Ann Hartley.Using the primary care assessment survey in an ambulatory setting[J].Nursing Economics,2002.
[18]刘运国,张亮,等.初级卫生保健机构绩效评价[M].北京:中国财政经济出版社,2007.
[19]Taylor RB.Family medicine:curent issues and future practice.In:RB Taylor ed.Family Medicine-Principles and Practice[J].New York:Springer,1998,1-5.
[20]梁万年,王红,杨兴华.中国城市社区卫生服务评价指标体系的建立.中国卫生事业管理,2002,8:460-462
[21]郭清,汪胜,王小合.中国城市社区卫生服务评价指标研究.中国全科医学,2002,5(11):887-888
[22]郭清,汪胜,王小合.2005年城市社区卫生服务发展目标评价方案的初步研究.中国初级卫生保健,2002,16(8):4-5
[23]孙晓明,梁鸿.从四维空间看社区卫生服务发展.中国卫生事业政策,2003,(1):24-26
[24]刘杭生,彭巨亚,吴耀宪等.保定市城市居民健康状况及卫生服务利用分析. 中国全科医学,2002,5(6):460-462
[25]刘艳,吴群鸿.哈尔滨市社区卫生服务需求、利用及影响因素分析.医学与社会,2002,15(1):11-13
[26]施学忠,谢婧,贾松树等.河南省卫生系统反应性模糊综合评价.中国卫生统计,2002,19(2):99-101
[27]Musgrove P.Judging health systems:reflections on WHO' s methods.Lancet.2003,24:1817-20
[28]Brundtland GH,Frenk J,Murray CJ.Who assessment of health systems performance.Lancet.
[29]World health organization,the world health report 2000:health systenm:improving performance printed in France,2000.144-150
[30]Po AL.The British National Health Service(NHS)celebrates its 50 th anniversary:equity in a competitive world.J Clin Pharm Ther 1998,23(4):241-2
[31]Dicks L.Breaking through to improved community health.Mich Health Hosp.2003,39(4):59-62
[32]Telfair J.An evaluation of state perinatal community-based programs in Alabama:overview.Public Health Rep.2003,118(5):484-6
[33]Eaves D.An evamination of the concept equity and the implications for health policy if equity is' re-asserted as one of the key govemment objectives for the National Health Service.J Nurs Manag.1998,6(4):215-21
[34]Paul F.Hogan,et al.Physical medicine and rehabilitation workforce study:the supply of and demand for physiatrists.Arcg Phys Med Rehabil,1996
[35]Calnan M,Almond S,Smith N.s.Ageing and public satisfaction with the health service an analysis of recent trends.Soc Sci Med.2003,57(4):575-62
[36]Roberts E.Consumer satisfaction in the Health Service:the orle of the Community Health Council. The current role: its scope and limitations. R Soc Health J . 1978,98(4):173-6
[37]Stanton P. Commpetitive health policies and community health. Soc Sci Med. 2001, 52(5): 671-9
[38]Waitzkin H. Connunity-based health care: contradictions and challenges. Ann Intern Med. 1983,98(2) :235-42
[39]Kunkel S. Assessing community needs. Issue Brief Cent Medicare Educ.2003;4(5):1-6
[40]Palmer GR. Evidence-based health policy-making, hospital funding and health insurance. Med J Aust, 2000,7;172(3):130-3
[41]Cashman SB, Bushnell FK, Fulmer HS. Community-oriented primary care: a model for public health nursing. J Health Polit Policy Law. 2001, 26(3): 617-34
[42]Aday L. A., Andersen R. M. A framework for the study of access to medical care. Health Services Research, 1974, 9:208
[43]Srinivasan S, O' Fallon LR, Dearry A. Creating healthy communities, healthy homes, healthy people:initiating a research agenda on the built environment and public health. Am J Public Health. 2003, 93(9):1446-50
[44]Kuller LH. On reconsidering community-based health promotion Am J Public Health. 2003, 93(8):1201;author reply 1201-2
[45]Brommels M, Jaaskelainen M. Measures of epuity and efficiency in medical manpower planning. A prediction of internists needed in the Finnish national health service. Health Policy. 1984, 4(1):3—11
[46]Birch S, Maynard A. Regional distribution of epuity in the National Health Service.Public Health. 1978, 92(4):190-6
[47]Ashton JR. R. A. W. P. The achievement of equity in the National Health Service. Public Health. 1978, 92(4):190-6
[48]Eaves D. An examination of the concept of equity and the inplications for health policy if equity is re-asserted as one of the key government objectives for the National Health Service. J Nurs-Manag. 1998, 6(4):215-21
[49]Price M. The consequences of health service privatisation for equality and equity in health care in South Africa. Sci Med. 1988, 27 (7): 703-16
[50]Tomoda W. Primary care design: health promotion centers—a new model for healthcare delivery.J Healthc Des. 1996,8:31-3
[51]Schlesinger M, Mitchell S, Gray B. Measuring community benefits provided by nonprofit and for-profit HMOs. Inquiry. 2003, 40(2): 114-32
[52]Oswald N.Access to what?Health care for whom? Health PAC Bull. 1992, 22(1): 28-30
[53]Abby Ghobadian, et al. 1994, Service Quality Concepts and Models. International Journal of Quality&Reliability Management, 11(9):43-46
[54]Judith A. Hall, Michael c. Doman. Meta-analysis of satisfaction with medical care: Description of research domain and analysis of overall satisfaction levels[J]. Soc Sci Med, 1988, 27(6):637-644
[55]Valentine N. De Silva A&Murray CJL. Estimating responsiveness level and distribution for 191 countries:methods and results. GPE Discussion Paper No. 22. Geneva, WHO, 2000
[56]Beauchesne MA, Meservey PM. An interdisciplinary community-based educational model. J Prof Nurs. 1999,15(1):38-43
[57] MacLean JR, Zon L. A healthy community through health system partnerships:the approach of Markham Stouffville HospitaL Healthc Pap. 2000, 1(2):96-103;discussion 104-7
[58] Janie Percy-Smith. Introduction: Assessing Needs Theory and Practice. In Janie Percy-Smith. Nurs. 1999, 15(1):38-43
[59]R. Sauerbom, A. Nougtara, H. J. Diesfeld. Low utilization of community health workers: Results from a household interview survey in Burkinga Faso[J].Soc Sci Med, 1989, 29(10): 1163-1174
[60]Surpin J. Hospitals and community health centers. Health Syst Rev. 1993, 26(1): 28-31
[61]Sheman,HD. Hospital efficiency measurement and evaluation. Medical Care,1984,10:022-935
[62]Hussey T. (1997)Efficiency and health. Nursing Ethics, 1997,3:181-190
[63]Taylor SA. Distinguishing service quality from patient satisfaction in developing health care marketing strategies. Hosp Health Serv Adm. 1994, 39 (2): 221-36
[64]Baker TL, Taylor SA. Patient satisfaction and service quality in the formation of customers' future purchase intentions in competitive health service settings. Health Mark Q 1997;15(1):1-15
[65]C. Darby, N. Valentine,C.JL Murray, at el. Strategy on measuring responsiveness. GPE Discussion Paper Series:No. 23, Geneva, WHO, 2001.1