分级诊疗制度下北京市某区基层医疗卫生机构发展现状分析

Analysis of the Status of Community Medical and Health Institutions in a Certain District of Beijing under the Tiered Diagnosis and Treatment System

目的:探究北京市某区分级诊疗制度运行状况,为政府完善和优化分级诊疗制度提供参考。方法:收集2015—2019年北京市某区基层医疗卫生机构卫生资源配置指标和医疗服务指标相关数据,采用Excel对数据进行整理及描述性分析。结果:5年间,基层医疗卫生机构数量总体呈逐年上升趋势,房屋面积也有了较大幅度的提升,万元以上设备台数逐年增长,年均增长率达20.41%。卫生技术人员数量明显增长,医护比有所升高,每千人口基层医疗机构床位数下降明显。病床使用率总体呈下降趋势,由2015年的96.19%下降至2019年的68.12%。基层医疗卫生机构诊疗人次数年均增长率达11.89%,2019年基层医疗卫生机构医师日负担诊疗量是2015年的1.26倍。结论:基层医疗卫生机构基础设施建设向好,居民的满意度提升,但门诊和住院技术力量分配不均衡,人员结构急需调整,在疾病康复、护理服务等功能上没有完全实现国家规定目标。

OBJECTIVE To explore the operation status of a hierarchical diagnosis and treatment system in Beijing,and to provide reference for the government to improve and optimize the hierarchical diagnosis and treatment policy.METHODS It collected relevant data on health resource allocation indicators and medical service indicators of a primary medical and health service institution in Beijing district from 2015 to 2019,and used Excel 2013 software for data collation and descriptive analysis.RESULTS In the past five years,the number of primary medical and health institutions increased year by year,and the housing area was also greatly improved.The number of equipment units of more than 10 000 yuan increased year by year,with an average annual growth rate of20.41%.The number of health technicians has increased significantly,the ratio of medical care has increased,and the number of beds in primary medical institutions per 1 000 people has decreased significantly.Overall,hospital bed utilization rates declined,decreasing from 96.19% in 2015 to 68.12% in 2019.The average annual growth rate of the number of patients in primary medical and health institutions reached 11.89%.In 2019,the daily burden of doctors in primary medical institutions was 1.26 times that in 2015.CONCLUSION The infrastructure construction of primary medical and health institutions was improving,and the people’s satisfaction was increasing,but the distribution of outpatient and inpatient technical forces was unbalanced,the personnel structure needed to be adjusted,and the national goals were not fully achieved in the functions of disease rehabilitation and nursing services.