完善分级诊疗,推进医改深化——基于石家庄市社区卫生服务机构就诊人群的调查
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摘要
目的了解石家庄市现阶段社区卫生服务机构就诊人群构成、医疗费用状况、就诊影响因素,为分级诊疗、上下级双向转诊制度的完善提供思路。方法于2017年1月13-20日,选取石家庄市15所社区医院就诊的患者,进行问卷调查。结果就诊人群在社区享受医疗报销的比例有待提高;社区卫生机构预防保健服务的利用率仍然较低;季节性多发病、慢性病成为社区疾病防治工作的重点;社区就诊具有方便、经济实惠的优势。结论社区医院应加强慢性病的防治管理;促进患者向社区分流;提高预防保健服务知晓率及利用率;改善社区卫生服务质量。
Objective: To understand the current medical population composition, medical cost status, and influencing factors of medical treatment in community health service institutions in Shijiazhuang, and to provide ideas for the improvement of the hierarchical diagnosis and treatment system and the two-way referral system.Methods: From January 13 to 20, 2017, patients from 15 community hospitals in Shijiazhuang were investigated by questionnaire. Results: The patients receiving medical reimbursement in the community needs to be improved. The utilization rate of preventive health services in community health institutions remains low. Seasonal frequently-occurring diseases and chronic diseases have become the focus of disease prevention and treatment in community. Community medical treatment has the advantages of convenience and economy. Conclusion: Community hospitals should strengthen the prevention and management of chronic diseases, promote the diversion of patients to the community, increase awareness rate and utilization rate of preventive health care services, and improve the quality of community health services.
Objective: To understand the current medical population composition, medical cost status, and influencing factors of medical treatment in community health service institutions in Shijiazhuang, and to provide ideas for the improvement of the hierarchical diagnosis and treatment system and the two-way referral system.Methods: From January 13 to 20, 2017, patients from 15 community hospitals in Shijiazhuang were investigated by questionnaire. Results: The patients receiving medical reimbursement in the community needs to be improved. The utilization rate of preventive health services in community health institutions remains low. Seasonal frequently-occurring diseases and chronic diseases have become the focus of disease prevention and treatment in community. Community medical treatment has the advantages of convenience and economy. Conclusion: Community hospitals should strengthen the prevention and management of chronic diseases, promote the diversion of patients to the community, increase awareness rate and utilization rate of preventive health care services, and improve the quality of community health services.
引文
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[2] 朱跃进.关于社区卫生服务纳入医保管理的实践与思考[J].江苏卫生事业管理,2006(3):66-67.
[3] 鲍科臻,周澹明.宁波市海曙区社区卫生服务中心门诊病人情况调查[J].中国全科医学,2005(13):1118-1119.
[4] Wei X,Zakus D,Liang H,et al.The Shanghai case:A qualitative evaluation of community health reform in response to the challenge of population ageing[J].Int J Health Plann Manage,2010,20(3):269-286.
[5] Englert HS,Diehl HA,Greenlaw RL.Rationale and design of the Rockford CHIP,a community based coronary risk reduction program:results of a pilot phase[J].Prev Med,2004,38(4):432-441.
[6] 王静雯.社区预防保健工作的思考与建议[J].健康教育与健康促进,2017(3):282-283.
[7] 张兴祥,王佩如.厦门市社区居民对分级诊疗的满意度及其影响分析[J].厦门特区党校学报,2018(4):40-45.
[8] 田瑶.石家庄社区卫生服务现状调查分析与对策建议[D].保定:河北大学,2017:34.
[9] 肖云芳,杨小丽.我国分级诊疗的实施困境及对策建议[J].医学争鸣,2017(5):49-52.