“和谐使命-2011”内科门诊特点分析和医师能力需求探讨

Analysis of characteristics of internal medicine clinic during 'Mission Harmony-2011' and exploration of capabilities requirements for internal medicine physicians

目的分析"和谐使命-2011"国外医疗服务内科门诊工作特点,探讨内科医师综合能力需求。方法回顾性分析门诊疾病总体分布情况;根据诊断结果分析内科疾病分布情况;分析内科门诊明确诊断的比率;对非明确诊断进行归类,统计各类症状或体征所占的比例;对专科医师接诊情况进行统计,分析专科医师接诊符合率。结果门诊内科患者最多,占总就诊量的28.82%;内科病种分布较广,心血管内科疾病最多,占35.95%;内科门诊诊断明确的占61.50%;非明确诊断患者中胸闷、胸痛类症状最多见,占31.03%;心血管内科和消化内科医师接诊本专科疾病符合率分别为28.46%和29.17%。结论内科门诊工作至少有两个特点:一是病种分布广;二是常以某一症状或体征为诊疗切入点。需要门诊内科医师具备一专多能的业务技能、较强的风险识别能力和风险应对能力。

Objective To analyze the characteristics of internal medicine clinic during aboard medical service in ＇ Mission Harmony -2011 ＇ and explore the capabilities requirements for internal medicine physicians. Methods General distributions of outpatient diseases and internal diseases were retrospectively analyzed according to diagnosis dlts. The ratio of internal medicine outpatients with definite diagnosis was calculated. Also the other patients without definite diagnosis were classified according to their chief com- plaints and the ratio of deferent symptoms or signs were calculated. The oatients who saw soecialist ohvsicians were analyzed andtheir coincidence ratios were calculated. Results Ontpatients of internal medicine occupied most （ 28.82% ） and their diseasesdistributed widely, most of which were canli aseular diseases （35.95%）. The ratio of internal medicine outpatients with definitediagnosis was 61.50%. In other patients without definite diagnosis, symptoms of lose heart, chest tightness or chest pain occupiedmost （31.03%）. The coincidence ratios ofphysicians who specialized in cardiology and gastroenterology dealing with specializeddiseases were 28.46% and 29.17% respectively. Conclusion There were two distinctive characteristics in outpatients of internalmedicine clinic during aboard medical service ： One was that diseases of internal medicine distributed widely, and the other was that some symptoms or signs might often be the entry point for treatment. Capabilities requirements for internal medicine physicians dur- ing aboard medical service should be involved at least in skill of specialization and multi-profession, and capability of strong risk recognition and response.