我国中西部县(区)乡镇卫生院诊疗能力调查

Medical diagnosis and treatment level of township health centers in China's central and western regions

目的 :分析中西部县(区)乡镇卫生院的诊疗能力现状及影响因素,为明确乡镇卫生院诊疗范围提供依据。方法 :选取了中部湖北省麻城市,以及西部重庆市黔江区为样本县(区),采用整群抽样方法对县(区)内46家乡镇卫生院的基本情况、医疗服务供给状况等9个部分开展调查,由业务院长给本院对乡镇卫生院最常见69种疾病的诊疗能力锚定打分。结果 :能够控制或治愈的疾病数超过48种的卫生院仅有10家;总收入、执业医师数、执业(助理)医师数、医技师数等9个因素与乡镇卫生院的诊疗能力相关。结论 :中西部县(区)乡镇卫生院诊疗能力低,作为首诊机构尚有风险;不同乡镇卫生院疾病诊疗能力差别较大;人员不足仍然是制约乡镇卫生院诊疗能力最大的瓶颈。

Objective ：To analyze the current medical diagnosis and treatment level of township medical centers and its influencing factors,and provide support to clarify a medical diagnosis and treatment package for township medical centers. Methods ：Macheng in Central China＇s Hubei Province and Qianjian in Western China＇s Chongqing Municipality were selected as sample counties. Forty-six township medical centers selected from every county by cluster sampling were surveyed on their basic information and medical treatment providing information,etc. The medical diagnosis and treatment for top 69 diseases from all the township medical centers were scaled by the business director based on behavior anchor rating scales. Results ：Only 10 among 46 township medical centers could control or cure more than 48 kinds of disease;nine factors including revenue,licensed doctor number,licensed（assistant） doctor number,medical technician number,etc. were correlated with the level of the medical diagnosis and treatment. Conclusion ：The medical diagnosis and treatment level of township medical centers was pretty low. There were some risks with these township medical centers being the first diagnosed institutions for the residents;the level varied significantly among township health centers. Human resources were the biggest bottleneck that would restrict the township medical centers＇ capability of medical treatment.