乡镇卫生院医疗服务能力趋势变化与问题探讨——基于2009-2015年山东省乡镇卫生院医疗服务量的比较

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英文篇名：Discussion on trend change and problem of medical health service ability in township hospitals——Based on comparison medical services amount of township hospitals in Shandong province from the year 2009 to 2015 作者：吴敏 ; 牟燕 ; 刘岩 ; 颜建华 ; 何有琴 英文作者：WU Min;MU Yan;LIU Yan;YAN Jian-hua;HE You-qin;Shandong Institute of Medicine and Health Information; 关键词：乡镇卫生院 ; 门急诊人次 ; 住院人次 ; 双向转诊 ; 山东省 英文关键词：township hospital;;person-time of outpatient;;person-time of hospitalization;;two-way referral;;Shandong province 中文刊名：WRKX 英文刊名：Soft Science of Health 机构：山东省医药卫生科技信息研究所; 出版日期：2018-01-15 出版单位：卫生软科学 年：2018 期：v.32;No.264 基金：山东省医学科学院医药卫生科技创新工程:基于分级诊疗的基层医疗卫生机构发展策略研究;; 山东省医药卫生科技信息研究所科研项目:山东省乡镇卫生院全科医生发展状况与薪酬研究;; 山东省医药卫生科技发展计划项目:山东省乡镇卫生院中医药服务建设现状与能力水平研究(2016WS0535) 语种：中文; 页：WRKX201801006 页数：4 CN：01 ISSN：53-1083/R 分类号：18-21

摘要

[目的]调查分析2009-2015年山东省乡镇卫生院医疗服务量变化趋势,探讨存在问题,为提高乡镇卫生院的服务能力提供参考依据。[方法]对山东省17市所辖所有乡镇卫生院进行问卷调查,共回收有效问卷1577份。统计分析2009-2015年山东省乡镇卫生院的门诊量、入院人数、转诊情况、二级及以下手术和住院分娩的数量变化趋势。[结果]2009-2013年乡镇卫生院门急诊和住院服务量呈现明显的上涨趋势,2013-2015年基本持平。2015年,乡镇卫生院的门急诊人次和住院人数分别比2009年增长了41.39%和25.91%;接收上级医院下转患者29123人,比2009年增长33.57%;向上级医院转出患者144823人,比2009年增长22.65%。上转患者是下转患者数量的5倍。乡镇卫生院开展二级及以下手术222269台(次),比2009年增长4.45%;正常分娩量44434人,比2009年下降了66.96%。[结论]乡镇卫生院的门诊和住院服务量近几年未见明显增长,上级医院下转患者仍处于"量效双低"状态,基层首诊、双向转诊目标短期内难以实现。乡镇卫生院开展二级及以下手术、正常分娩的服务能力明显弱化,外科、妇产科等专科医疗能力亟待提升。
        Objective To analyze trend change of medical services amount of township hospitals in Shandong province from the year 2009 to2015,discuss existing problem so as to provide reference basis for improving service ability of township hospitals. Methods Questionnaire survey was conducted to 17 township hospitals in Shandong province. Total of 1577 effective questionnaires were collected. It analyzed numbers change trend of outpatient,hospitalization,referral status,surgery under grade 2 and hospitalization delivery. Results From 2009 to 2013,person trip of outpatient and numbers of hospitalization service showed obvious op-trend. From 2013 to 2015,it held the line. In 2015,person-time of outpatient and numbers of hospitalization increased 41. 39% and 25. 9% which compared with in 2009. Received 29123 referral patients from higher-ups hospitals,it increased 33. 5% compared in 2009. Rolled out 144 823 referral patients to higher-ups hospitals,it increased 22. 65% compared in 2009. The number of higher-ups referral patients were 5 times of lower referral patients. There were 222 269 under Grade Two surgery in township hospitals,it increase d 4. 45% compared in 2009. The number of normal delivery in township hospitals was 44 434,which decreased 66. 96% compared with in 2009. Conclusions There was no significant growth of outpatient and hospital service in township hospitals in recent years. The situation of higher-ups hospital referral to lower is still in"both of quality and efficiency low". It was difficult to achieve the goal of first treatment in grassroot and two-way referral in the short term. The capacity of surgery,obstetrics and gynecology and other specialist medical care should be improved.

引文

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