我国6县(区)乡镇卫生院住院利用现状

The current hospitalized service utilization among six township medical centers,China

目的 :了解当前我国不同地区乡镇卫生院住院服务利用现状及存在的问题。方法 :在我国东、中、西部地区分别抽取2个县作为样本县(区),以新农合数据库为数据来源抽取6个样本县(区)2012—2013年所有的住院数据。运用Excel 2010和SPSS 22.0软件对数据进行描述性统计和卡方检验。结果 :东、中、西部地区乡镇卫生院住院人数占比例依次增大,分别为9.91%、45.35%和51.14%;各地区乡镇卫生院与县级医疗机构在住院疾病类别占比上均存在显著差异(三地区P<0.001);乡镇卫生院的住院实际报销比,中部(91.93%)>东部(56.23%)>西部(46.40%);仅在县级住院人数比例,东部(81.65%)>西部(44.36%)>中部(35.47%)。结论 :地区间乡镇卫生院住院服务利用水平差距大;各地区乡镇卫生院的住院疾病类别占比存在差异;新农合住院实际报销比一定程度上影响患者住院机构选择。

Objective ：To investigate the current situation and problems on hospitalized service utilization among township medical centers in China＇s different areas. Methods ：Two counties were selected as samples from each of the eastern,middle and western regions of China. All the inpatient data were collected from 2012 to 2013 in six sample counties on the basis of New Rural Cooperative Medical database. Descriptive statistics,Chi-square test were done by Excel 2010 and SPSS 22.0. Results ：From the east to the west,the proportion of inpatients choosing township medical centers presented trend of increasing from 9.91%,45.35% to 51.14%. The difference of inpatient disease composition between township medical centers and county medical institutions was significant（PE〈0.001;PM〈0.001;PW〈0.001）;the inpatient reimbursement ratio（91.93%）was highest from township medical centers in the middle areas;the second was the east areas（56.23%）and the lowest was the west areas（46.40%）;the ratio of hospitalizing only in county medical institution in the east,west and middle areas were 81.65%,44.36% and 35.47%,respectively. Conclusion ：There is a great gap of hospitalized-service-utilization among township medical centers in different regions. The composition of inpatient diseases among township medical centers in different regions is different. Hospitalized compensation ratio influences the residents＇ medical institutions selection to some extent.