江苏省社区医院门诊服务供给影响因素分析

Analysis on the Impact Factors of the Outpatient Service Supply of Community Hospitals in Jiangsu Province

目的:调查江苏省社区医院门诊服务供给现状并探索相关影响因素,为推进社区医院建设提供参考。方法:采用统一设计的调查表对江苏省210家社区医院的人员、科室设置、服务量等情况开展调查,采用秩和检验、多元线性回归分析门诊量影响因素。结果:全省社区医院的主要投入、产出指标均高于基层机构平均水平。结论:社区医院建设有效提升了基层医疗服务能力,但基层医疗机构在诊疗科室的设置上要不断适应居民健康需要;基层护理人力资源建设有待加强;不同区域、规模、水平的基层机构转设社区医院的路径有待进一步研究。

To investigate the current situation and impact factors of outpatient service supply in community hospitals in Jiangsu Province,in order to provide references for promoting the construction of community hospitals.Methods:A self-adminis-tered questionnaire was used to investigate the professionals,infrastructures,clinical department settings and service capacity of a to-tal of 210 community hospitals in Jiangsu Province.Wilcoxon test and multiple linear regression were used to analyze the impact fac-tors of outpatient service supply.Results:The input indexes and output indexes of community hospitals are higher than all primary health care institutions in Jiangsu.Community health service centers with otolaryngology,hospice,and geriatrics departments,as well as township hospitals with pediatrics,ophthalmology and psychiatric departments,have a higher annual outpatient visits than institu-tions without relevant clinical departments(P<0.05).Multifactorial analysis showed that the average annual outpatient visits per physi-cian is significantly positively associated with income per capita,while negatively correlated with the ratio of physicians to nurses and bed size.Conclusions:Community hospital construction effectively improved the medical service capacity of primary health care insti-tutions.Primary health care institutions need to constantly adapt to the health needs of the people when setting clinical departments.The construction of the primary nursing human resources needs to be further strengthened.The pathways of transferring primary health care institutions of different regions,sizes and levels to community hospitals should be further studied.