政府购买绩效合同管理模式对农村公共卫生服务的影响

摘要

目的 分析政府购买绩效合同管理模式对农村公共卫生服务公平性和效率的影响.方法 采用随机对照法、机构调查法和公共卫生服务对象问卷调查法,调查乡镇居民对国家基本公共卫生服务利用情况及公平性和效率.结果 试点县服务对象对于居民健康档案管理、儿童健康管理、高血压和2型糖尿病患者健康管理服务的利用是较高质量的绝对公平,Gini系数值均＜0.2,且CI值接近于0.试点县乡镇的公共卫生服务提供总体、技术和规模有效性均优于非试点县的乡镇.结论 政府购买绩效合同管理模式有利于改善农村公共卫生服务的公平性,且提高服务效率.%Objective To analyze the impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas.Methods Randomized controlled method,agency investigation and questionnaire survey on public health services recipients were used.Results The utilization of residents health records management services,child health management services,health care management of patients with hypertension and type 2 diabetes in pilot counties was higher quality absolutely fair.Gini＜0.2,CI≈0.The overall effectiveness,technical validity and effectiveness of scale of the townships in pilot counties were better than that in non-pilot county.Conclusion This management mode helps to improve the equity of public health services and service efficiency.