西部少数民族地区乡镇卫生院医疗服务供给状况调查

The medical service supply of township health centers in western minority areas of China

目的了解西部少数民族地区乡镇卫生院基本医疗服务供给状况,为制定相关措施与政策提供科学依据。方法采用多阶段抽样方法选取桂林市的乡镇卫生院,应用国家卫健委出台的《乡镇卫生院服务能力评价指南(2019版)》评价医疗服务病种、医疗技术服务内容与水平。结果共调查6县(区)49家乡镇卫生院;门诊排名前10位的病种为上呼吸道感染、高血压、咽炎、支气管炎、外伤、扁桃体炎、糖尿病、关节炎、皮炎和胃肠炎,住院病种主要为呼吸道疾病(支气管炎、肺炎、肺部感染)和肌肉骨骼系统疾患(腰椎间盘突出、混合型颈椎病、关节炎、腰椎骨质增生和腰痛等),达91.93%;与国家建议相比,乡镇卫生院能够识别和初步诊断病种均低于50%,开展医疗技术服务项目为36.26%,不同乡镇卫生院开展的医疗技术项目不一样。结论目前西部少数民族地区乡镇卫生院的医疗服务供给水平较差、能力较低下,难以满足分级诊疗的基本要求,其建设与提升仍需要进一步加强,需要各级政府的高度重视。

Objective To know about the supply of basic medical services of township health centers in western minority areas of China and to provide scientific basis for taking measures and making policies.Methods The multi-stage sampling method was used to select township health centers in Guilin City,and the types of medical services and the content and level of medical technical services were evaluated by the"Service Ability Evaluation Guide for Township Health Centers(2019 Edition)"issued by the National Health Commission.Results A total of 49 township health centers in 6 counties(districts)were investigated.Top 10 diseases treated in outpatient department were upper respiratory tract infection,hypertension,pharyngitis,bronchitis,trauma,tonsillitis,diabetes,arthritis,dermatitis and gastroenteritis.The main inpatients'diseases were respiratory diseases(bronchitis,pneumonia,lung infection)and musculoskeletal system diseases(lumbar disc herniation,mixed cervical spondylosis,arthritis,lumbar bone hyperplasia and lumbago,etc.),accounting for 91.93%.Compared with the national recommendations,township health centers were able to identify and initially diagnose less than 50%of the diseases,and 36.26%of the medical technical services were carried out.The medical technical services carried out by different township health centers were different.Conclusions The capacity of medical service supply in township health centers of western minority areas of China is inadequate,which cannot meet the needs of hierarchical diagnosis and treatment.The building and improvement of the medical services still needs to be further strengthened and governments at all levels need to attach great importance to it.