目的：分析2012年重庆一区两县基本公共卫生服务项目实施中存在的问题，为基本公共卫生服务项目的开展提供有益的借鉴。方法2013年3—4月，采用分层随机抽样的方法，选取重庆市九龙坡区、璧山县和奉节县为调查区县，由当地卫生行政部门及项目监管和实施部门提供相关资料，并对卫生局主管领导进行深度访谈。结果九龙坡区、璧山县和奉节县平均每千人所拥有的基层卫生人员或基层执业（助理）医师分别为0.64、2.39、1.64人，人均基本公共卫生服务费标准分别为29、30、25元。3个区县2012年的健康档案建档率均≥80.00％，计划免疫建证率均达到了100.00％，高血压患者的管理率为30.00％~40.00％，2型糖尿病患者的健康管理率为30.00％~40.00％，重性精神疾病患者的规范管理率均≥80.00％。新生儿访视率、儿童健康管理率及儿童系统管理率均≥80.00％。孕产妇剖宫产率分别为53.46％、70.00％和44.57％，均超出了世界卫生组织15％~20％的标准。老年人健康体检表完整率均≥90.00％。传染病及突发公共卫生事件报告和处理工作的所有考核基本达标。结论重庆市基本公共卫生服务项目总体开展情况良好，但高血压、2型糖尿病和重性精神疾病患者的健康管理工作有待提高，孕产妇剖宫产率均超出世界卫生组织标准；主要原因是基层医疗卫生机构缺乏专业技术人员，资金不足，居民参与度待提升。%Objective To analyze the existing problems in the implement of primary public health service projects (PPHSP)in 1 district and 2 counties,to provide beneficial reference for the performance of PPHSP. Methods From March to April 2013,jiulongpo District,Bishan County,Fengjie County were enrolled in this study by stratified sampling. The relevant information was supplied by departments of local medical administration and those of project supervision and the officials were interviewed. Results In jiulongpo,Bishan,Fengjie,there were averagely 0. 64,2. 39,1. 64 grass - root health workers or assitand medical prectitioners and practitioners per thousand inhabitants,respectively;the primary public health service fees that the government supplied were 29,30,25 Yuan per capita. The rates of inhabitantsˊ health records establishment were all ≥80. 00% ,the holding rates of planned immunization certificates all reached 100. 00% ;the management rates of hypertension patients were 30. 00% - 40. 00% ;those of T2DM patients were 30. 00% - 40. 00% ;the standard management rates of severe mental illness were ≥80. 00% ;the neonatal visit rates,child health management rates and systematic management rates were all≥80. 00% ;the cesarean section rates were 53. 46% ,70. 00% ,44. 57% ,respectively,higher than the WHO standards (15% - 20% );the integrality rates of elderly health examination forms were all ≥90. 00% ;the indicators for performance appraisal of reports and dealing of infectious diseases and public health emergencies met the requests basically. Conclusion The PPHSP have been performed well generally,but the managements of patients with hypertension,T2DM and mental disease need to be improved,the rate of maternal cesarean section exceeds WHO standards,the main reasons of which are shortness of professional and technical personnel,fund shortage and low inhabitantsˊ participation.
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