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目的:了解沈阳市妇幼机构运营状况,为机构自身建设和卫生行政部门决策提供信息。方法:依托中国疾病预防控制中心妇幼保健中心妇幼保健机构监测信息网络直报系统和相关调查表,对沈阳市16个妇幼保健机构运营状况进行调查。结果:①沈阳市妇幼保健机构基本情况:市级和县级为独立机构,区级分别有9.10%机构隶属CDC,18.20%隶属医院;调查的56.25%的机构为全额拨款事业单位,25.00%为全额/差额拨款,18.72%为差额拨款;6.25%有住院服务,93.75%无住院服务。②人力资源情况:按照1986年卫生部颁布的《各级妇幼保健机构编制标准》中规定的编制标准,市级编制平均缺乏65人,区县级平均缺少30.73人。基层妇幼保健人员学历和职称偏低;平均每个妇幼保健机构在职职工总数49.44人,市级127人,区县级44.27人;每个机构平均卫生技术人员39.75人,市级96人,区县级36人;按照1995年我国《妇幼保健机构评审标准》,沈阳市市级75.59%不达标,区县级81.32%达标;市级机构本科以上学历占卫生技术人员的57.29%,区县级占22.22%;副高以上职称市级机构占卫生技术人员的34.38%;区县级机构占5.92%;市级机构保健人员与群体保健人员占职工总数的51.97%和7.09%,区县级机构占职工总数的43.82%和18.07%;专业技术人员继续医学教育的费用占机构业务年收入的6.92%,继续医学教育达标率99.19%。③资产情况:沈阳市级机构建房屋面积2 070 m2,区县级1199.18 m2。④运营情况:沈阳市妇幼保健机构平均总收入615.91万元,市级业务收入(含医疗和药品收入之和)2 100.45万元,区县级160.01万元。妇幼保健机构总收入构成显示,财政补助收入市级399.08万元,区县级316.64万元。沈阳市级每年门诊量60 490人次,区县级平均11 511.2人次。结论:①沈阳市妇幼保健机构以独立形式和全额拨款为主;②沈阳市妇幼保健机构人力资源不足;③市区县及购建房屋面积均低于全国平均水平;④财政投入经费总额市区县级高于全国平均水平,门诊量低于全国平均水平。
Objective: To understand the operation status of women and children institutions in Shenyang and to provide information for the self-construction and decision-making of health administrative departments. Methods: Relying on the direct reporting system of maternal and child health monitoring information network of MCH center of China Center for Disease Control and Prevention and related questionnaires, the operation status of 16 MCH institutions in Shenyang was investigated. Results: (1) The basic situation of MCH institutions in Shenyang: Independent agencies at the municipal and county levels, with 9.10% of the institutions affiliated to the CDCs and 18.20% of the affiliated hospitals respectively; 56.25% of the institutions surveyed were fully funded institutions, 25.00% In full / shortfall, 18.72% is the difference; 6.25% has inpatient services and 93.75% does not have inpatient services. ② Human Resources: According to the compilation standards stipulated in the “Compilation Standards for MCH Institutions at all Levels” promulgated by the Ministry of Health in 1986, there are an average of 65 people lacking in city-level compilation and an average of 30.73 people missing in districts and counties. The average number of working maternal and child health workers in each MCH institution is 49.44, with 127 persons at municipal level and 44.27 persons at district and county level. The average number of health technicians in each institution is 39.75, with 96 persons at municipal level. Level 36; in accordance with the “Evaluation Standards for Maternal and Child Health Care Institutions” in 1995, Shenyang Municipality level 75.59% did not meet the requirements, and the district and county levels reached 81.32%; municipalities with bachelor degree or above accounted for 57.29% of health technicians, 22.22% of the total number of staff and workers; 34.38% of the municipal health workers and technicians were deputy chiefly staff or above; 5.92% of district-level and county-level agencies; 51.97% and 7.09% of health workers and group health workers of municipal agencies accounted for 51.97% and 7.09% 43.82% and 18.07% of the total number of employees. The cost of continuing medical education for professionals and technicians accounted for 6.92% of the annual income of the institution’s business and the compliance rate of medical education continued to reach 99.19%. ③ Assets: Shenyang municipal agencies built 2,070 m2 of houses and 1199.18 m2 of districts and counties. ④ Operation status: The average total income of Shenyang MCH institutions was 6.1591 million yuan, the revenue from municipal services (including the sum of medical and pharmaceutical products income) was 21.04 million yuan, and the district and county level was 1.6601 million yuan. The composition of the total income of MCH institutions shows that the financial subsidy income was 3.9908 million yuan at municipal level and 3.1664 million yuan at district and county level. The number of outpatients per year in Shenyang is 60,490, with an average of 11,512.2 at district and county level. Conclusion: (1) Shenyang MCH institutions are dominated by independent and full funding; (2) human resources of MCH institutions in Shenyang are inadequate; (3) urban districts and the area of houses purchased and built are lower than the national average; (4) District level higher than the national average, out-patient volume below the national average.