成都基层乡镇卫生院住院医疗服务现况调查分析

Investigation and Analysis on the Present Situation of Hospitalization Medical Service in Chengdu Grass-roots Township Hospitals

目的调查成都市乡镇卫生院住院服务利用现状,分析其影响因素。方法 2016年10月至11月,采用普查法,对成都市全域22个区县(市)乡镇卫生院开展问卷调查,采用自填式结构问卷,对2015年1月至12月乡镇卫生院的住院服务量进行调查,采用单因素和多因素logistic回归分析其影响因素。结果成都市乡镇卫生院264所,开通住院服务的机构数量为252所,年住院服务量529611人次、每千人床位数1.9张,病床使用率75.53%;单因素分析结果显示:执业医师人数、药事人员人数、护士人数、医技人员人数、全科医生人数、服务人口人数、平均每千人口执业医生数、收治住院病种数、病床使用率、急诊量及门诊量对住院服务量影响有统计学意义(P<0.05); logistic多因素回归分析显示:门诊量、收治住院病种数、病床使用率及护士人数是影响住院服务量的重要影响因素。结论成都地区乡镇卫生医疗机构还需进一步提升门诊服务能力,调整资源投入结构,提高病床等各类资源的利用效率,优化人力资源配置,通过制定更有针对性的管理措施提高住院服务能力。

Objective To investigate the utilization status of hospitalization service in Chengdu Township Health Center and analyze its influencing factors.Methods From October to November 2016,a questionnaire survey was conducted among township hospitals in all 22 districts and counties(cities)of Chengdu with the method of census.A self-filled structured questionnaire was used to investigate the quantity of in-patient service in township health centers from January to December 2015.Univariate and multivariate logistic regression analysis were used to analyze the influencing factors.Results There were 264 township health centers in Chengdu,among which the number of institutions offering hospital service was 252,the annual hospital service volume was 529611 people,the number of beds per thousand people was 1.9,and the utilization rate of hospital beds was 75.53%;The results of univariate analysis showed that:the number of practicing doctors,medical personnel,nurses,medical technicians,general practitioners,service population,the average number of practitioners per thousand population,the number of hospitalized diseases,bed utilization rate,emergency and outpatient volume had statistical significance on the number of hospitalized services(P<0.05);Logistic multivariate regression analysis showed that the number of outpatients,the number of hospitalized diseases,the utilization rate of hospital beds and the number of nurses were the important factors affecting the quantity of in-patient service.Conclusion The township health and medical institutions in Chengdu area still need to further enhance the capacity of outpatient services,adjust the structure of resources input,improve the utilization efficiency of beds and other resources,optimize the allocation of human resources,through the formulation of more targeted management measures to improve the capacity of hospitalization services.