乡镇卫生院医疗服务提供的回顾性研究

Retrospective Research on Medical Service Supply of Township Hospitals

目的:回顾性分析乡镇卫生院的医疗服务提供,为促进乡镇卫生院的可持续发展提供理论支持。方法:以2010-2017年中国卫生和计划生育统计年鉴数据为基础,以县级医院为对照,从绝对值和相对值两个方面对乡镇卫生院的门诊和住院服务提供变化情况进行分析,并从科室分布角度分析乡镇卫生院医疗服务提供的结构变化。结果:乡镇卫生院的门诊服务绝对量年增长率为3%,住院服务绝对量波动较大但变化趋势不明;乡镇卫生院的门诊服务相对量年下降率为4.3%,住院服务相对量的年下降率为9.2%;东、中、西部地区乡镇卫生院门诊服务相对量的年下降率分别为4.8%、3.4%和4.4%,住院服务相对量的年下降率分别为7.8%、9.4%和10.6%。与2009年相比,2016年乡镇卫生院内科和中医科的入院人数占比分别升高了7.1和2.6个百分比,外科、儿科和妇科的入院人数占比分别下降了2.0、0.7、4.8个百分比。结论:乡镇卫生院在农村卫生服务体系中的作用不可替代,但其地位在持续下降,且与地域无关;乡镇卫生院的医疗业务结构发生了改变,外科、儿科和妇科服务功能减弱。

Objective： To promote sustainable development of township hospitals by performing a retrospective study on the medical service supply. Methods： The study was performed based on China Health and Family Planning Statistical Yearbook from 2010 to 2017. Outpatient and inpatient service supplies of township hospitals were analyzed by using both absolute and relative values, and compared with that of county hospitals. Furthermore, departmental structures of township hospitals were also evaluated. Results： The absolute value of the outpatient service supply from township hospitals was growing at a rate of 3% per year, while the inpatient service fluctuated greatly. The relative value of the outpatient service supply from township hospitals was descending at a rate of 4.3% per year and the inpatient service was descending at a rate of 9.2% per year. The relative value of outpatient service supply for eastern, central and western area were descending at rate of 4.8%, 3.4% and 4.4% per year. The relative value of inpatient service supply for eastern, central and western area were descending at rate of 7.8%, 9.4% and 10.6% per year. Compared with 2009, the inpatient portion for internal medicine department and Chinese traditional medicine department had a 7.1 and 2.6 percent increase in 2016, and the inpatient portion for surgery, pediatrics, and gynecology department had a 2.0, 0.7 and 4.8 percent decline in 2016. Conclusion： The role of township hospitals in the rural health service system remains irreplaceable, while its status is declining continuously and has nothing to do with regions. The medical service structure of township hospitals has also been changed, and the service function of surgery, pediatrics, and gynecology is weakened.