Objective To learn the cognitions of community medical staff and residents to pooling funds of outpatient service in medical insurance in the pilot community health service ( CHS ) centers of Changsha city so as to provide the basis for implementation of the pooling funds of outpatient service. Methods The cluster random sampling was taken in Changsha city during 2011 to recruit 199 members of medical staff from 10 CHS organizations and 295 residents from 3 communities where the pooling funds had been implemented, and 152 from 9 CHS organizations and 296 residents from 3 communities where the pooling funds was not implemented. The questionnaire survey and depth interviews were conducted among the subjects to learn their cognitions of the pooling funds. Results There was a statistically significant difference in understanding on the fooling funds of outpatients service between the medical staff from CHS organizations where the pooling funds had been implemented and those from CHS organizations where the pooling funds was not implemented ( P <0. 05 ) . After the implementation of the pooling funds, 87. 7% of the medical staff pointed out that the residents' satisfaction improved, 86. 0% believed the number of visits increased, 71.5% thought that the medical care level was generally improved and the doctor - patient relationship became more harmonious, and 58. 1% held that the economic efficiency was raised in CHS organizations. And there was a statistically significant difference in understanding on the fooling funds of outpatients service between the residents from communities where the pooling funds had been implemented and those from communities where the pooling funds was not implemented ( P < 0. 05 ) . Conclusion Both the community medical staff and residents believe that the implementation of the pooling funds of outpatient service is conducive to improve the level of primary health care services, and reduce health care costs. And it is closely related to the relevant supporting policies, community medical technology level, and connection with superior medical institutions.%目的 了解长沙市医保门诊统筹试点社区卫生服务机构的社区医务人员和辖区居民对医保门诊统筹的认知状况,为促进门诊统筹的实施提供依据.方法 于2011年采取整群抽样的方法抽取长沙市已开展门诊统筹的10家社区卫生服务机构以及未开展门诊统筹的9家社区卫生服务机构的医务人员进行调查,其中已开展门诊统筹社区的医务人员199名,未开展门诊统筹社区的医务人员152名;再分别随机抽取3个已开展门诊统筹的社区和3个未开展门诊统筹的社区,在每个社区中各随机抽取社区居民100名,其中已开展门诊统筹的社区295人,未开展门诊统筹的社区296人.通过问卷调查及定性访谈,了解社区医务人员及居民对门诊统筹工作的认知情况.结果 已开展与未开展医保社区门诊统筹的社区卫生服务机构医务人员对医保社区门诊统筹的了解程度间差异有统计学意义(P＜0.05).有87.7%的医务人员觉得开展门诊统筹后居民对社区卫生服务机构的满意度提高了;86.0%的医务人员认为开展门诊统筹后就诊人数增加了;71.5%的医务人员认为开展后医疗水平整体上升了,医患关系更加和谐了;58.1%的医务人员认为开展门诊统筹后社区卫生服务机构的经济效益提高了.已开展与未开展医保社区门诊统筹的社区卫生服务机构辖区居民对医保社区门诊统筹的了解程度间差异有统计学意义(P＜0.05).结论 社区医务人员和居民均认为医保门诊统筹的开展有助于提高基层医疗服务水平,降低医疗费用.医保社区门诊统筹的开展与相关配套政策、社区卫生服务机构的医疗技术水平以及与上级医疗机构的衔接等紧密相关.
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