摘要
目的通过对京山市紧密型医疗共同体实施后县、乡两级医疗机构卫生服务效率的影响进行分析,为进一步推动我国医疗共同体建设提供参考依据。方法以湖北省京山市紧密型医疗共同体为研究对象,采用间断时间序列分析医疗共同体政策实施前后县级医院和基层医疗机构门急诊量、门诊次均费用、出院患者数量、住院次均费用、病床使用率等指标变化趋势。结果医疗共同体政策实施后,对县级医院门急诊量、出院患者数量、住院次均费用、平均住院日和病床使用率均有影响(P<0.05),对基层医院门诊例均费用和出院患者数量有影响(P<0.05)。医疗共同体政策实施后县级医院卫生服务效率提高,基层医疗机构服务水平逐步提高。结论要进一步加强县级医院的医疗服务水平,提升专科能力建设、打造优势专科,提升县域就诊率和县域救治能力。加强县级医院对基层医院的精细化统筹管理,整合全县医疗资源,促进医防融合工程建设,提高人民群众健康“守门人”的能力。
Objective It analyzed the impact of the health service efficiency of medical institutions at county and township levels after the implementation of the county medical alliance in Jingshan City,so as to provide a reference for further promoting the construction of the medical community in China.Methods In this study,the close-knit county medical alliance in Jingshan City,Hubei Province was taken as the research object.Interrupted time series analysis was used to analyze the change trends of indicators such as the number of outpatient and emergency patients,the average cost of outpatient cases,the number of inpatients,the average cost of inpatients,and the utilization rate of hospital beds in county-level and community-level medical institutions before and after the implementation of the medical community policy.Results After the implementation of the medical community policy,the number of outpatient and emergency visits,the number of discharged patients,the average cost of hospitalized cases,the average length of stay and the utilization rate of hospital beds in county hospitals were all affected(P<0.05);The average cost of outpatient cases and the number of discharged patients in primary hospitals were affected(P<0.05).After the implementation of the medical community policy,the service efficiency of county-level hospitals has improved,and the service level of community-level medical institutions has gradually improved.Conclusion It is necessary to further strengthen the level of medical services in county hospitals,enhance the capacity construction of specialized departments,create competitive specialties,and improve the attendance rate and treatment capacity at the county level.We should strengthen the fine and overall management of county-level hospitals to basic-level hospitals,integrate the medical resources of the county,promote the construction of the integration project of medical treatment and prevention,and improve the ability of“gatekeeper”of people’s health.
作者
袁姣
叶霖
陈训军
郭晨霞
高和平
YUAN Jiao;YE Lin;CHEN Xun-jun(Union Hospital,Tongji Medical College Huazhong University of Science and Technology,Wuhan,Hubei,430022,China;不详)
出处
《中国医院管理》
北大核心
2021年第12期69-72,共4页
Chinese Hospital Management
基金
国家自然科学基金项目(81974280)
湖北省卫生健康科研基金资助项目(WJ2021M251)。
关键词
医疗共同体
卫生服务效率
间断时间序列
county medical alliance
health service efficiency
interrupted time series analysis
