潍坊市基层医疗机构慢性呼吸系统疾病防治卫生资源配置现状研究

A survey of the status quo of health resources allocation for the prevention and treatment of chronic respiratory diseases in primary medical institutes in Weifang

目的了解潍坊市基层医疗机构慢性呼吸系统疾病防治的卫生人力、设备和药品等资源配置现状。方法2015年12月—2016年1月,采用分层整群抽样方法对潍坊市19家二级医院、48家社区卫生服务中心/乡镇卫生院和413家社区卫生服务站/村卫生室负责人进行问卷调查。结果①在卫生人力配置方面,二级医院、社区卫生服务中心/乡镇卫生院和社区卫生服务站/村卫生室职工均以初级职称为主,分别占43.5%、50.2%和63.6%,二级医院职工以大学学历为主,占41.6%,社区卫生服务中心/乡镇卫生院和社区卫生服务站/村卫生室职工以高中及以下学历为主,分别占44.2%和86.2%;②在慢性呼吸系统疾病诊疗设备方面,肺功能仪在二级医院、社区卫生服务中心/乡镇卫生院和社区卫生服务站/村卫生室中的配置率分别为73.7%、14.6%和1.0%,峰流速仪仅在二级医院进行配置,配置率为31.6%,其他机构均无配置;③在慢性呼吸系统疾病治疗药物方面,吸入长效β2-受体激动剂在二级医院、社区卫生服务中心/乡镇卫生院和社区卫生服务站/村卫生室中的配置率分别为73.7%、18.8%和14.5%,抗胆碱能药物的配置率分别为78.9%、10.4%和6.8%。结论目前潍坊市基层医疗机构慢性呼吸系统疾病的防治存在检查设备缺乏、吸入长效β2-受体激动剂和抗胆碱能药物等疾病长期管理用药配置不足等问题,应加大简易肺功能仪和简易峰流速仪等检查设备及吸入长效剂型药物在基层医疗机构的普及,并加强对基层医生关于慢性呼吸系统疾病防治知识和肺功能检查操作技术的培训力度。

Objective To understand the current situation of health resources allocation, covering human resources, equipment allocation and pharmaceutical setting for the prevention and treatment of chronic respiratory diseases in primary medical institutes in Weifang. Methods The questionnaire survey was conducted among 19 secondary hospitals, 48 com- munity health service centers/township hospitals and 413 community health service stations/village clinics, investigating the person in charge and using stratified cluster sampling method, from December, 2015 to January, 2016 in Weifang. Results ① In terms of health manpower, in secondary hospitals, community health service centers/township hospitals and community health service stations/village clinics, workers are mainly with primary title, accounting for 43.5%, 50.2% and 63.6% respectively, who in second hospitals 41.6% are mainly with college degree, and in other institutes mainly with high school degree or below, accounting for 44.2% and 86.2%. ② In terms of the equipment for the treatment of chronic respiratory diseases, the distribution rate of respiratory function instruments are 73.7% , 4.6% and 1.0% respectively in secondary hospitals, community health service centers/township hospitals and community health service stations/village clinics, the peak flow meters are only in secondary hospitals, allocation rate is 31.6% , community health service centers/ township hospitals and community health service stations/village clinics have no peak flow meters.③In terms of the drugs for the chronic respiratory diseases therapy, in secondary hospitals, community health service centers/township hospitals and community health service stations/village clinics, the distribution rate of inhaled long-acting beta 2-agonists are 73.7%, 18.8% and 14.5%, and the distribution rate of anticholinergics are 78.9%, 10.4% and 6.8%. Conclusion Primary medical institutes in Weifang are currently lack of respiratory function instruments, peak flow meters and drugs for long management of chronic respiratory diseases, for instance, inhaled long-acting beta 2-agonists and anticholinergics, so the coverage of mini respiratory function instruments, mini peak flow meters and inhaled long-acting drugs should be ex- panded, and the training of knowledge about prevention and treatment of the chronic respiratory diseases and pulmonary function testing operations aimed to primary medical institutes doctors should be strengthened.