小康型乡镇卫生院特色专科建设及效益评估

Construction of specialty clinic in well-off level township hospitals and efficiency evaluation

目的建立小康型乡镇卫生院特色专科创建模式并进行效益评估。方法针对特色专科创建模式的拟定、筛选、运行、应用等,采用文献分析、定性访谈、焦点小组讨论和专家咨询的方法收集有关情报和咨询意见,筛选出适宜模式进行应用验证。结果通过在双流县永安中心卫生院开展的小康型乡镇卫生院特色专科创建,各专科药品比例下降,门诊人均诊疗费用均低于全国同期水平;科室诊疗人次、经济收入均得到大幅提升;同时三个专科总诊疗人次由32.76%提高到46.6%,总诊疗人次提高幅度大于医疗总收入提高幅度,表明农村居民到特色专科就诊的相对医疗费用在下降。结论 "特色专科三元素"是创建和发展特色专科的必要条件。创建特色专科为健全农村三级医疗卫生网络提供了重要支撑,能够提升基层医院的诊疗水平,减轻患者负担。

Objective To establish and validate a specialty clinic model in a well-off township hospital. Methods An optimal model for specialty clinic was screened out based upon creation mode, operation and application by using methods including literature a- nalysis, qualitative interview, group discussion and expert consultation. In order to demonstrate its validation, the model was preliminarily applied in a township hospital. Results After establishment of specialty clinic at the Yong^an Township Center Hospital, the specialty pharmaceutical proportion was reduced and medical expense per outpatient was lower than national level at the same period. Office visits and economic income have increased substantially. At the same time, specialist visits accounted for hospital visits in three specialty clinics were increased from 32.76% to 46.6% , suggesting that medical expense of rural residents for specialty clinics was reduced. Conclusion ＂The three elements of specialty clinics＂ are the necessary conditions for construction and development of specialty clinics in well-off township hospital. The creation of specialty clinics will provide an important support for perfecting rural three tier health network which will improve the levels of diagnosis and treatment of primary hospital, and reduce the burden of patients as well.