【作者】 孙德俊；

【导师】 齐二石；

【作者基本信息】 天津大学 ， 工业工程， 2009， 博士

【摘要】 如何科学地做好社区卫生服务发展规划与设计,优化资源配置,节约建设投资,提高管理质量,对社区卫生服务可持续发展有着深远的意义和影响。本研究的意义在于:能够最大限度地满足社区居民基本医疗卫生服务需求;使有限的卫生资源得到充分利用;促进卫生公平,构建和谐社会。本文结合城市社区卫生服务发展特点,以先进的管理思想为基础,透过科学发展观的视角,采用公共卫生学、卫生经济学以及运筹学的理论与方法,针对当前城市社区卫生服务发展规划与设计亟待解决的关键问题,提出社区卫生服务管理和资源配置的系统设计思想。对社区卫生服务机构的选址与建设、运行与优化、改进与发展等三个阶段分别进行了优化布局、服务能力与需求匹配决策以及服务绩效评价与改善等研究。主要做了以下工作:1.提出城市社区卫生服务机构配置理论和选址模型。以覆盖所有城镇人口和新增投资最低为目标,提出了规划模型,分别用于选择整合原有医疗点和建设新机构。在此基础上,又建立了将部分社区卫生服务机构发展成为社区卫生服务中心的决策模型。2.从需要、公平和效益进行资源配置决策分析。以Lorenz曲线和Gini系数表示的公平性为目标,综合考虑重点人口服务对公平性的影响以及服务机构内资源配置量与服务能力的关系,做出服务需求和服务能力的匹配决策,改变以往仅仅从区域人口分布公平性出发来决策卫生资源配置的局限性。同时对社区公共卫生服务配置适宜量进行了决策测算。3.提出了城市社区卫生服务绩效评价的指标体系。4.以某城市社区卫生服务发展为背景,对文中研究成果进行了实证应用,并取得了很好的效果。5.对本文工作进行总结,并对未来需要拓展深入研究的内容进行了展望。更多还原

【Abstract】 How to do the community health service development planning and design scientificly, optimizie the allocation of resources, save capital investment and improve the quality of management, has far-reaching significance and impact for sustainable development of the community health services. This study is about: to maximize to meet the commnuity the basic needs of medical and health services; to make the best of the limited health resources; promote the health fair, building a harmonious society.This thesis combines the characteristics of the development of urban community health service , based on of the advanced management ideas , through the perspective of Scientific Concept on Development ,using the theory and method of Public Health, Health Economics and Operations Research, aiming at the key problems which are needed to be resolved urgently in the current urban community health service planning and development Design , puts forward the system design thinking of the Health Service Management and Resource Allocation . This thesis makes the research of layout optimization, services ability and matching the requirements decisions as well as measurement and improvement of the services performance for the location and construction of the Community Health Services ,operation and optimization, improvement and development etc three phases. The main work are as follows:1.Putting forward the theory of Community Health Service Configuration and the Location Model. Coming up with a Planning Model aiming for minimuming all the urban populations and the additional investment to be used in the integration of the originalf health care and building new institutions. On this basis, setting up a Decision Model which is to make some Community Health Services Institutes into Community Health Service Center as well.2.Making the decision analysis for resource allocation from the point of need, fair and efficiency. With a view to the fairness indicated by the Lorenz curve and Gini modulus, considering comprehensively the impact that the target population services play on the fairness and the relationship between the volume of the resource allocation in the Service Institutions and Service capability,make a matching decision between Service Requirements and Service Capability,change the limitations in the past in the making the health resource allocation decision only from the fairness of the regional population distribution. At the same time, decide and measure the appropriate volume of the community public health services allocation.3.Putting forward the index system of the urban community health service performance appraisal.4.Be set in the development of some urban community health services,demonstrate and carry out the research findings in the paper,and achieve very good effect.5.Sum up this particle, prospect the content needed to expand and study in the future.更多还原