应用可避免住院疾病指标评价基层医疗服务质量

To Evaluate the Quality of Primary Medical Service by Using Indicators of Ambulatory Care Sensitivity Conditions

目的应用院外服务敏感疾病(ACSCs)指标探讨医共体常见的可避免住院疾病,评价基层医疗服务质量,提出针对性改进建议。方法分析福建省某县域医共体牵头医院的病案数据。分析变量是NHS-ACSCs各指标的住院比例,其他变量包含患者人口学特征以及合并症情况。采用SAS 9.3版软件进行统计分析。结果前十位常见ACSCs住院疾病依次是流感和肺炎、慢性阻塞性肺疾病、耳鼻喉感染、脱水和肠胃炎、充血性心力衰竭、高血压、痉挛和癫痫、心绞痛、糖尿病并发症、气喘。ACSCs住院与患者年龄、合并症情况显著相关。结论应用ACSCs评估医共体基层服务质量时,应根据不同年龄群体选择合适指标,以增加ACSCs的敏感度。

Objective To apply Ambulatory Care Sensitivity Conditions(ACSCs)indicators to assess the common avoidable hospitalization diseases in a medical alliance,evaluate the quality of primary medical services and put forward relevant suggestions for improvement.Methods The medical record data of the leading hospital of a county medical community in Fujian Province was analyzed.The analysis variable was the hospitalization rate of each ACSCs indicator,and other variables included patient demographic characteristics and comorbidity.The SAS 9.3 software was used for statistical analysis.Results The top 10 most common ACSCs hospitalizations were influenza and pneumonia,chronic obstructive pulmonary disease,ear,nose and throat infection,dehydration and gastroenteritis,congestive heart failure,hypertension,seizures,angina,diabetic complications,and asthma.ACSCs hospitalization was significantly correlated with age and comorbidities of patients.Conclusion When using ACSCs to evaluate the quality of service at the primary level of the medical alliance,appropriate indicators should be selected according to different age groups to increase the sensitivity of ACSCs.