四川省分级诊疗效果评价:以呼吸系统疾病为例

Evaluation of the Effect of Hierarchical Medical System in Sichuan Province:Takeing Respiratory Diseases as An Example

目的对四川省分级诊疗效果进行分析,并提出建议。方法以四川省2018年350家二级及以上综合医院126万余条呼吸系统疾病住院患者的数据为基础,利用DRGs方法从医疗服务供给模式和服务效率两个维度进行分级诊疗效果分析和评价。结果呼吸系统住院患者共覆盖40个DRGs疾病组,二级及以上综合医院均能提供诊疗服务,三级综合医院患者占62.94%,其中79.21%为普通疾病,20组疾病平均住院日和38组疾病例均住院费用均高于二级综合医院。结论四川省分级诊疗效果不明显,患者流向以三级综合医院为主,普通疾病患者占三级综合医院患者比例较高,二级综合医院治疗普通疾病效率更高。

Objective To analyze the effect of hierarchical medical system in Sichuan Province and put forward some suggestions.Methods Using DRGs to analyze and evaluate the effect of hierarchical medical system from the two dimensions of medical service supply mode and service efficiency,based on the data of more than 1.26 million inpatientss with respiratory diseases in 350 second-level and above general hospitals in 2018.Results A total of 40 DRGs disease groups were covered by respiratory inpatients,and the second-level and above general hospitals could provide diagnosis and treatment services.The tertiary general hospitals accounted for 62.94%of patients,and 79.21%of whom were common diseases.The average length of stay in 20 groups of diseases and 38 groups of diseases had higher hospitalization costs than the second-level general hospitals.Conclusion The effects of hierarchical medical system were was not obvious in Sichuan Province.Patients were mainly in tertiary general hospitals,and most of them with common diseases,and the secondary hospitals were more efficient in treating common diseases.