上海市郊区新建三级公立医院优势病种分析

Analysis of the Dominant Diseases of Tertiary Public Hospitals Newly Built in Suburbs in Shanghai

目的通过分析上海市郊区新建4家三级公立医院优势病种数据,评估新院试点改革的运行情况。方法根据母院临床重点专科分布,选取内外科优势病种,通过收集2013—2014年优势病种的医疗服务数据及费用资料,从优势病种服务量、费用以及效率3个维度,对比新院与母院优势病种数据,评价上海市郊区新建三级公立医院提供优质医疗服务水平。结果 2013—2014年,新建郊区三级公立医院与母院相比,内外科优势病种服务量具有潜在的上升空间,新院内外科优势病种次均费用低于母院,内科病种效率高于母院,但外科病种效率仍有提高空间。结论从优势病种上看,郊区新建三级医院初步达到优化医疗资源布局、阶段性改善优质医疗资源服务的目标;从长远来看,仍需建立科学分诊机制,明确医院服务定位,引导区域卫生需求合理分布。

Objective Through analyzing the data of dominant diseases in 4 tertiary public hospitals newly built in suburbs in Shanghai,the operation of these new-built hospitals in the pilot reform was evaluated.Methods Based on the distribution of key clinical departments in each mother hospital,the dominant diseases from both internal medical and surgical departments were chosen.The service and cost data of these hospitals＇ dominant diseases from 2013 to 2014 were collected.By comparing both the new-built hospitals in the suburb and the mother hospitals,high quality medical service level of suburb newly built tertiary public hospital was evaluated.Results During 2013—2014,the service amount of both internal medical and surgical dominant diseases of public hospitals new-built in suburb had big potential.Compared with the mother hospitals,new-built hospitals＇ per-time cost of both internal medical and surgical dominant diseases were lower.The new-built hospitals＇ internal departments had better efficiency than the mother hospitals.There was room for new-built hospitals＇ surgical departments to improve efficiency.Conclusion By analyzing the domain diseases data,the newly built tertiary hospitals in suburb has basically accomplished the aim,which was to optimize the distribution of medical resources and improve the high-qualified medical service providing for short stage.In the long run,a scientific triage mechanism to guide a rational distribution of regional health needs and a clear definition of both new-built and mother hospitals＇ service role were demanded on edge.