Abstract: Background　We determined the service content and process of diabetes management through literature review and expert consultation at the early stage.The labor division of medical personnel in community health service centers was defined as well.How to combine the division of labor and practice process of diabetes management in community health service centers to calculate the standardization workload of each diabetes management service in the community，which has become the key to solving the distribution of diabetes management performance in the community.Objective　To calculate the standardization workload of diabetes management services provided by Wujiaochang Community Health Service Center and to lay the foundation for the rational distribution of diabetes management performance in community health service centers.Methods　Fifty five representatives from diabetes management in Wujiaochang Community Health Service Center were selected from April to June，2018.The self-developed e-questionnaire was used through wenjuanxing，an online platform that can be used for questionnaires，exams or voting，to gather the standardization workload measurement data of diabetes management services in communities.The human and time consumption，technical difficulty，risk level，authoritative degree of subjects and similar items between different departments were collected to estimate the standardization workload of various services in diabetes management.The data analysis was carried out under the Excel 2016.Results　There was a total of 29 diabetes management services in the community and each diabetes management service was completed by one person independently，whose occupation types and titles were primary nurse，general practitioner，and laboratory physician.The least time-consuming service was urine sugar qualitative test （4.38 min），and the most time-consuming service was the general outpatient consultation fee （13.33 min）.The service with least technical difficulty was waist measurement，and service with most technical difficulty was medication.The service with the lowest risk was health record （retrieve and recovery），and service with the highest risk was drug treatment.The service with the smallest standardization workload was urine sugar qualitative test，which was 0.25，and the service with the largest standardization workload was the general outpatient examination，which was 1.00.Conclusion　Based on the division of labor and practice processes of diabetes management in community health service centers，the standardization workload of community diabetes management services is measured，which can be used to guide the rational distribution of diabetes management performance in the community.

Key words: Community health centers, Diabetes mellitus, Disease management, Workload, Performance distribution

摘要： 背景　项目组前期通过文献回顾和专家咨询，整合了糖尿病管理的服务内容和服务流程，明确了社区卫生服务中心各类医务人员的分工。如何结合社区卫生服务中心糖尿病管理工作分工和实践流程，科学合理地核算各项社区糖尿病管理服务的标化工作量，成为解决社区糖尿病管理绩效分配的关键。目的　测算上海市杨浦区五角场镇社区糖尿病管理服务的标化工作量，为社区卫生服务中心糖尿病管理绩效的合理分配奠定基础。方法　于2018年4—6月选取上海市杨浦区五角场镇社区卫生服务中心糖尿病管理工作执行人55例，采用自行编制的调查问卷通过问卷星发放电子问卷，采集社区糖尿病管理服务标化工作量测算资料，评价基本人力消耗与耗时、技术难度、风险程度，评判调查对象权威程度，记录不同科室间的相似项目，测算各项社区糖尿病管理服务项目的标化工作量，采用Excel 2016软件进行数据分析。结果　社区目前开展的糖尿病管理服务项目共29项，各项糖尿病管理服务项目均由1人独立完成，所需工种和职称分别为护士初级、全科初级、检验初级；耗时最短的项目是尿糖定性试验（4.38 min），耗时最长的项目是普通门诊诊查费（13.33 min）；技术难度最低的项目是腰围测量，技术难度最高的项目是药物治疗；风险程度最低的项目是健康档案（调取与回收），风险程度最高的项目是药物治疗；尿糖定性试验的标化工作量最小，为0.25；普通门诊诊查费的标化工作量最大，为1.00。结论　本研究基于社区卫生服务中心糖尿病管理工作分工和实践流程，测算了社区糖尿病管理各项服务的标化工作量，可用于指导社区糖尿病管理绩效的合理分配。

关键词: 社区卫生中心, 糖尿病, 疾病管理, 工作负荷量, 绩效分配