公共卫生服务均等化背景下基层社区卫生服务建设差异分析

Analysis of the Differences in Community Health Service Construction under the Background of Public Health Service Equalization

摘要: 背景：随着中国“健康中国2030”规划的实施，基层医疗卫生服务体系逐步发展，社区卫生服务在保障居民健康方面发挥着越来越重要的作用。然而，城乡差异和地区差异依然存在，影响着公共卫生服务的均等化。目的：本研究旨在分析2017至2023年期间，中国社区卫生服务中心的数量、人员配置及服务能力的变化，探讨城乡差异和地区差异对基层卫生服务资源配置的影响，进而提出提升社区卫生服务均等化的对策建议。方法：本研究采用描述性统计分析方法，基于国家统计局和国家卫生健康委员会发布的相关数据，重点分析社区卫生服务中心数量、床位数、卫生人员数等指标的变化趋势，并结合城乡和地区差异进行比较。结果：研究发现，2017~2023年间，全国社区卫生服务中心数量稳步增长，但增速逐渐放缓，尤其是城乡差异和地区差异依然显著。东部地区的服务资源明显优于中西部地区，城市社区卫生服务中心数量和卫生人员配置高于农村和西部地区，造成了城乡医疗资源不均衡的现象。此外，尽管全科医生数量和基本公共卫生服务项目得到一定扩展，基层卫生人员仍面临短缺问题。

Abstract: Background: With the implementation of China’s “Healthy China 2030” plan, the grassroots medical and health service system has gradually developed, and community health services have played an increasingly important role in safeguarding residents’ health. However, urban-rural and regional disparities still exist, affecting the equalization of public health services. Objective: This study aims to analyze the changes in the number, staffing, and service capacity of community health service centers in China from 2017 to 2023, explore the impact of urban-rural and regional disparities on the allocation of grassroots health service resources, and propose strategies to enhance the equalization of community health services. Method: The study adopts descriptive statistical analysis methods, based on data released by the National Bureau of Statistics and the National Health Commission, focusing on the trends in the number of community health service centers, bed numbers, health personnel, and other indicators, and comparing them across urban-rural and regional differences. Results: The study found that from 2017 to 2023, the number of community health service centers nationwide grew steadily, but the growth rate gradually slowed down, with significant urban-rural and regional disparities remaining. The service resources in the eastern region are significantly better than those in the central and western regions, with urban community health service centers and health personnel allocation being higher than those in rural and western areas, leading to an imbalance in urban-rural medical resources. Additionally, although the number of general practitioners and basic public health service projects has expanded, grassroots health personnel still face shortages.