重庆市基层中医药健康管理服务效果评价与改进策略研究*

作者：罗 静1，徐 燕2，刘 陈2

单位：1.重庆理工大学管理学院，重庆 400054； 2.重庆市巴南区中医院，重庆 400055

引用：引用：罗静，徐燕，刘陈.重庆市基层中医药健康管理服务效果评价与改进策略研究[J].中医药导报,2026,32(5):269-274.

DOI：10.13862/j.cn43-1446/r.2026.05.043

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摘要：

目的：调查重庆市基层中医药健康管理服务开展的情况，并提出优化策略。方法：基于Donabedian评价模型，从结构、过程和结果3个维度构建了包含19个二级指标的中医药健康管理服务效果评价体系，对重庆市抽取的14个区县基层机构的中医药健康管理服务展开调查，分析存在的问题。结果：尽管重庆市基层中医药服务覆盖率整体提升，但全市中医药健康服务综合评价平均得分仅为43分（百分制），超过64%的区县得分低于平均分；基础资源投入评分呈现两极分化，全市平均得分37.69分，最高得分（73.82分）约为最低得分（10.41分）的7倍；在指导过程与服务效果两项满分为5分的指标中，平均得分却分别低至1.78分、1.82分。此外，服务获得形式、知晓度、满意度、可及性和获得服务种类的平均分（满分5分）分别是2.55分、2.80分、3.47分、3.58分和3.01分，而受访人群平均利用率仅为7.14%。结论：重庆市基层中医药健康管理服务存在基层扩面动力不足、管理过程干预能力薄弱、中医药服务供需脱节等问题。基于此，可通过重塑服务供给逻辑，实现“保基本、服务跟人走”的服务供给模式；强化管理过程干预，构建权责明晰的闭环管理体系；精准匹配群众核心需求，优化中医药服务资源配置效率、多维度协同，全面提升重庆市基层中医药健康管理服务能力。

关键词：基层中医药健康管理服务；重庆市；效果评价；改进策略

Abstract：Objective: To investigate the implementation of primary-level traditional Chinese medicine (TCM) health management services in Chongqing and propose optimization strategies. Methods: Based on the Donabedian evaluation model, an evaluation system for TCM health management services including 19 secondary indicators was constructed from three dimensions: structure, process and outcome. A survey was conducted on TCM health management services in primary-level institutions across 14 districts/counties in Chongqing to identify existing problems. Results: Although the overall coverage rate of primary-level TCM services in Chongqing had improved, the average comprehensive evaluation score of TCM health services in the city was only 43 points (out of 100), and more than 64% of districts and counties scored below the average. The scores of basic resource investment showed polarization, with an average score of 37.69 points across the city, the highest score (73.82 points) was about seven times the lowest score (10.41 points). For the two indicators of guidance process and service effect with a full score of 5 points, the average scores were as low as 1.78 points and 1.82 points respectively. In addition, the average scores (full score 5 points) for service access form, awareness, satisfaction, accessibility and service types available were 2.55, 2.80, 3.47, 3.58 and 3.01 respectively, while the average utilization rate among respondents was only 7.14%. Conclusion: There are problems in primary-level TCM health management services in Chongqing, including insufficient motivation for primary coverage expansion, weak intervention capacity in management process, and disconnection between supply and demand of TCM services. Accordingly, improvements can be made by reshaping the service supply logic to realize a service supply model of "ensuring basic needs while providing services along with individuals"; strengthening management process intervention to construct a closed-loop management system with clear rights and responsibilities; accurately matching the core needs of residents, optimizing the allocation efficiency of TCM service resources, and promoting multi-dimensional coordination to comprehensively improve the capacity of primary-level TCM health management services in Chongqing.

Key words：primary-level traditional Chinese medicine health management services; Chongqing; effect evaluation; improvement strategies

发布时间：2026-05-24

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