發(fā)布時(shí)間：2018-03-16 20:08

  本文選題：分級(jí)診療　切入點(diǎn)：實(shí)施效果　出處：《中國(guó)全科醫(yī)學(xué)》2017年31期 　論文類型：期刊論文

【摘要】：目的探討北京市朝陽(yáng)區(qū)分級(jí)診療實(shí)施效果,分析存在的問(wèn)題,為分級(jí)診療制度的進(jìn)一步完善提供政策建議。方法收集2015年8月—2016年9月北京市朝陽(yáng)區(qū)26家醫(yī)聯(lián)體成員單位的調(diào)查數(shù)據(jù)和朝陽(yáng)區(qū)42家社區(qū)衛(wèi)生服務(wù)中心的績(jī)效考核數(shù)據(jù)。采用醫(yī)療服務(wù)量、雙向轉(zhuǎn)診量、醫(yī)務(wù)人員交流情況及基本醫(yī)療服務(wù)指標(biāo)得分評(píng)價(jià)朝陽(yáng)區(qū)的分級(jí)診療實(shí)施效果。結(jié)果與2015年相比,2016年朝陽(yáng)區(qū)醫(yī)聯(lián)體內(nèi)上級(jí)醫(yī)院的門診人次、急診人次及住院人次分別增長(zhǎng)了3.45%、14.55%、13.78%,基層醫(yī)療衛(wèi)生服務(wù)機(jī)構(gòu)的門診人次、急診人次及住院人次分別增長(zhǎng)了8.52%、5.63%、28.27%。與2015年相比,2016年北京市朝陽(yáng)區(qū)醫(yī)聯(lián)體下轉(zhuǎn)就診人次增長(zhǎng)了67.34%,上級(jí)醫(yī)院向基層醫(yī)療衛(wèi)生服務(wù)機(jī)構(gòu)下派專家數(shù)增長(zhǎng)了544.33%。2016年42家社區(qū)衛(wèi)生服務(wù)中心的居民健康檔案管理、老年人健康管理、醫(yī)療質(zhì)量得分與2015年比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);高血壓患者健康管理、2型糖尿病患者健康管理得分高于2015年,合理用藥得分低于2015年(P0.05)。結(jié)論朝陽(yáng)區(qū)開(kāi)展醫(yī)聯(lián)體框架下的分級(jí)診療工作取得了一定成效,上級(jí)醫(yī)院和基層醫(yī)療衛(wèi)生服務(wù)機(jī)構(gòu)的醫(yī)療服務(wù)量均有所增長(zhǎng),下轉(zhuǎn)就診人次增多,基層醫(yī)療衛(wèi)生服務(wù)機(jī)構(gòu)的慢性病管理能力得到提高,但合理用藥方面仍有待加強(qiáng)。
[Abstract]:Objective to explore the effect of hierarchical diagnosis and treatment in Chaoyang District of Beijing, and analyze the existing problems. Methods from August 2015 to September 2016, the survey data of 26 medical conjoined units in Chaoyang District, Beijing, and the performance of 42 community health service centers in Chaoyang District were collected. Nuclear data. Use of medical services, Two-way referral, medical staff exchange and the score of basic medical service index were used to evaluate the effect of graded diagnosis and treatment in Chaoyang District. Results compared with 2015, the outpatient visits of higher level hospitals in Chaoyang District were compared with those in 2015. The number of emergency cases and the number of hospitalizations increased by 3.45%, 14.55% and 13.78%, respectively, and the number of outpatient visits of primary medical and health services, The number of emergency cases and hospitalizations increased by 8.52%, 5.63% and 28.27% respectively. Compared with 2015, the number of people transferred to medical institutions in Chaoyang District of Beijing on 2016 increased by 67.34, and the number of specialists sent by higher hospitals to primary medical and health service institutions increased by 544.33% in 42 communities during the period of 2016. The management of residents' health files in health service centers, There was no significant difference in the scores of health management and medical quality between 2015 and 2015, and the scores of health management in patients with hypertension and type 2 diabetes mellitus were higher than those in 2015. The scores of rational drug use were lower than that in 2015 (P 0.05). Conclusion in Chaoyang District, the graded diagnosis and treatment work under the framework of medical conjoined system has achieved some results, the quantity of medical services in higher hospitals and primary medical and health service institutions has increased, and the number of people turning to medical service has increased. The ability of chronic disease management in primary health care institutions has been improved, but the rational use of drugs still needs to be strengthened.
【作者單位】： 北京市朝陽(yáng)區(qū)疾病預(yù)防控制中心慢病科;北京市朝陽(yáng)區(qū)衛(wèi)生和計(jì)劃生育委員會(huì);北京市朝陽(yáng)區(qū)社區(qū)衛(wèi)生服務(wù)管理中心;
【分類號(hào)】：R197.1

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