摘  要：目的：本研究通过对杭州市基层医疗卫生机构中医药服务能力的现状进行调查研究。探讨和分析影响基层医疗机构中医药服务能力的关键因素，并提出相应对策。

方法：本次研究采用文献法收集国内外相关研究和政策法规，并在咨询专家的基础上制定调查问卷。应用问卷调查法抽样调查了杭州市6个区共8个社区卫生服务中心中医药服务现状。通过Epidata、Excel、SPSS21.0对数据进行处理和分析。

结果：所调查的社区卫生服务中心均设置了中医综合服务区，中医业务用房面积占比12.80%；中药饮片服务都能覆盖辖区内社区卫生服务站，中药饮片数量均超过300种，都配备有基本中医诊疗器具；平均中医医生人数为14人，占比为26.85%；老年人平均中医药健康管理率为42.49%，儿童平均中医药健康管理率为67.40%；中医药适宜技术开展种类数均达到6种；平均中医药门诊量占比为22.47%；7家社区卫生服务中心都实现收支平衡或略有赤字，2016年平均中医药收入占比为18.47%，2016年平均中医药支出占比为10.50%。

结论与建议：被调查社区卫生服务中心基础条件基本达标；中医药卫生技术人员人数基本达到标准；中医药服务提供量有所增长但仍有不足；特殊人群健康管理率较低；中医药收入、支出占比较低。提出以下建议：充实基层中医药人才，提升人才素质；强化中医特色优势，丰富中医服务内容；加大中医药适宜技术推广力度;加强医保政策对中医的倾斜，完善政策补偿机制。

关键词：杭州市； 基层医疗卫生机构； 中医药； 服务能力

abstract：Objective: To investigate the status of traditional Chinese medicine ( TCM ) service ability in community health service centers in Hangzhou. To explore and analyze the key factors affecting the service ability of traditional Chinese medicine in community health service centers, and put forward the corresponding countermeasures.

Methods: This study used literature method to collect relevant research , policies and regulations at home and abroad, and on the basis of consulting experts to develop a questionnaire. The present situation of traditional Chinese medicine ( TCM ) service in 8 community health service centers in 6 districts of Hangzhou was investigated by questionnaire. Epidata, Excel and SPSS 21.0 were used to process and analyze the data.

Results: All the community health service centers surveyed set up TCM comprehensive service areas, and the area of TCM business rooms accounted for 12.80 %. Chinese herbal medicine service can cover within the jurisdiction of the community health service station, the number of Chinese herbal medicine are more than 300 kinds, are equipped with basic Chinese medicine diagnosis and treatment equipment; The average number of doctors of traditional Chinese medicine is 14, accounting for 26.85%; The average Chinese medicine health management rate of the elderly was 42.49 %, and the average Chinese medicine health management rate of children was 67.40 %. There were 6 kinds of suitable technology of TCM. The average outpatient quantity of traditional Chinese medicine accounted for 22.47 %; Seven community health service centers have achieved balance of payments or a slight deficit, the average revenue of traditional Chinese medicine in 2016 accounted for 18.47 %, the average expenditure of traditional Chinese medicine in 2016 accounted for 10.50 %.

Conclusion and suggestion: the basic conditions of the investigated community health service center are basically up to standard; Traditional Chinese medicine health technical personnel to meet the basic standards; The provision of traditional Chinese medicine services has increased but is still insufficient; The health management rate of special population is low; Traditional Chinese medicine income and expenditure accounted for relatively low. Put forward the following suggestions:Enrich the grass-roots Chinese medicine talents, improve the quality of personnel; Strengthen the advantages of traditional Chinese medicine, enrich the service content of traditional Chinese medicine; Strengthen the promotion of appropriate technology of traditional Chinese medicine; To strengthen the medical insurance policy on the tilt of traditional Chinese medicine, improve the policy compensation mechanism