北京市朝阳区分级诊疗实施效果研究

发布时间：2018-03-16 20:08

本文选题：分级诊疗　切入点：实施效果　出处：《中国全科医学》2017年31期 　论文类型：期刊论文

【摘要】：目的探讨北京市朝阳区分级诊疗实施效果,分析存在的问题,为分级诊疗制度的进一步完善提供政策建议。方法收集2015年8月—2016年9月北京市朝阳区26家医联体成员单位的调查数据和朝阳区42家社区卫生服务中心的绩效考核数据。采用医疗服务量、双向转诊量、医务人员交流情况及基本医疗服务指标得分评价朝阳区的分级诊疗实施效果。结果与2015年相比,2016年朝阳区医联体内上级医院的门诊人次、急诊人次及住院人次分别增长了3.45%、14.55%、13.78%,基层医疗卫生服务机构的门诊人次、急诊人次及住院人次分别增长了8.52%、5.63%、28.27%。与2015年相比,2016年北京市朝阳区医联体下转就诊人次增长了67.34%,上级医院向基层医疗卫生服务机构下派专家数增长了544.33%。2016年42家社区卫生服务中心的居民健康档案管理、老年人健康管理、医疗质量得分与2015年比较,差异无统计学意义(P0.05);高血压患者健康管理、2型糖尿病患者健康管理得分高于2015年,合理用药得分低于2015年(P0.05)。结论朝阳区开展医联体框架下的分级诊疗工作取得了一定成效,上级医院和基层医疗卫生服务机构的医疗服务量均有所增长,下转就诊人次增多,基层医疗卫生服务机构的慢性病管理能力得到提高,但合理用药方面仍有待加强。
[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.
【作者单位】：北京市朝阳区疾病预防控制中心慢病科;北京市朝阳区卫生和计划生育委员会;北京市朝阳区社区卫生服务管理中心;
【分类号】：R197.1

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