河南省县级临床重点专科医疗服务能力发展情况分析

Analysis of the Development of Medical Service Ability of County-level Clinical Key Specialty in Henan Province

目的了解河南省2014年首批县级临床重点专科的医疗服务量和效率、医疗技术能力与质量的现状及发展情况,发现该批重点专科在医疗服务方面取得的进展以及存在的问题,推动县级临床重点专科发展,提升县级医院服务能力。方法通过问卷调查收集2011—2013年与2014—2016年数据,应用EpiData3.1进行数据录入,采用SPSS19.0软件进行配对t检验、配对秩和检验。结果河南省首批县级临床重点专科卫生服务量各项指标提升,差异有统计学意义(P <0.05);服务效率方面平均住院日下降,差异有统计学意义(P <0.05);专科特色技术项目数增加,差异有统计学意义(P <0.05);亚专科建设、临床技术、创新项目开展及应用在两个阶段变化差异无统计学意义(P> 0.05);常见病治愈率、疑难病种好转率提高,差异有统计学意义(P <0.05);医疗质量各项指标改善,差异有统计学意义(P <0.05);药占比、门诊患者抗菌药物使用比例下降,差异有统计学意义(P <0.05)。结论河南省首批县级临床重点专科卫生服务量和工作效率明显提高,常见病、疑难病种的诊疗能力提升,医疗质量显著改善,用药更加合理。应加强重点专科技术特色建设,进一步降低药占比,提升医疗卫生服务能力。

Objective To grasp the status quo and development of medical service quantity and efficiency,as well as medical technical capability and quality of the first county-level clinical key specialties in Henan Province,discover the progress and issues of medical service capacity,promote the county-level clinical key specialty,and improve the service capacity of county-level hospitals.Methods Related data was investigated and collected through questionnaire from 2011 to 2013 and from 2014 to 2016.Data was entered and the database was set up by EpiData3.1,and paired t test and signed rank sum test were conducted via SPSS19.0.Results The improvement of indexes of service quantity and the decline of the average hospital stay of the first county-level clinical key specialties in Henan Province are observed(P<0.05).The increase of specialized technical projects amount is statistically significant(P<0.05),whereas the subspecialty construction,as well as the development and application of clinical technology and innovative project are not verified(P >0.05).The advancement of cure rate of common disease and the rate of recovery of difficult diseases is statistically significant(P<0.05).There is improvement of indexes of medical quality,with statistically significant difference(P<0.05).Drug proportion and the proportion of antimicrobial drug use in outpatient drops,and the differences are statistically significant(P<0.05).Conclusion The medical service quantity and quality and efficiency of the first county-level clinical key specialties in Henan Province improves significantly.The ability of diagnosis and treatment of common and difficult diseases improves.Medical quality improves significantly.And the use of drugs is more reasonable.The key technical characteristic construction should be enhanced,and drug proportion should descend continually,to elevate medical service capability.