北京市某区整合型医疗服务的实践效果研究  

Practice Effect of Integrated Health Services in A District of Beijing

作　　者：刘永泉[1] 钟军[2] 董朝晖[3] 沈秀萍 彭真[1] 孙振球[1] 

机构地区：[1]中南大学公共卫生学院,湖南省长沙市410078 [2]北京大学公共卫生学院 [3]人力资源和社会保障部社会保障研究所 [4]北京市海淀区社区卫生服务管理中心

出　　处：《中国全科医学》2012年第34期3948-3950,共3页Chinese General Practice

摘　　要：目的了解基层医疗服务和二级及以上医疗服务整合的效果,为实施整合型医疗服务提供依据。方法在北京市某区选取具有整合型医疗服务特征的(由二级及以上医院举办的)10个社区卫生服务中心和不具有整合型医疗服务特征的(由非二级及以上医院举办的)17个社区卫生服务中心作为研究对象,比较分析两类社区卫生服务中心的医疗服务情况。结果实行整合型医疗服务的社区卫生服务中心卫生人员人均年门急诊人次数为(1 527.0±861.1)人次、上转率为(48.6±43.6)/万、下转率为(0.6±0.4)/万,均高于非整合型医疗服务的社区卫生服务中心,分别为(785.2±353.4)人次、(18.9±18.0)/万和(0.2±0.1)/万,差异有统计学意义(P<0.05)。多元回归模型拟合结果显示,举办类型对卫生人员人均年门急诊人次、上转率和下转率有影响。结论整合型医疗服务对于提高社区卫生服务机构的门急诊服务能力、建立向上和向下转诊渠道具有促进作用。Objective To know about the effect of integration of primary and secondary or higher - leveled medical services, so as to provide empirical evidences for carrying out integrated health services. Methods Totally 10 community health service centers held by secondary or higher -leveled hospital carrying out integrated health services, and 17 community health service centers held by other ownership without the integrated health services in a District of Beijing were chosen as the subjects, and the conditions of medical services in the two types of community health service centers were comparatively analyzed. Results In the centers carrying out integrated health services, for per capita doctor, the average number of handled outpatient and emergency cases yearly was （ 1 527. 0 ±861.1 ） person - times, the upward referral rate was （48.6 ±43.6） /per ten thousand, and the downward referral rate was （0. 6 ±0.4） / per ten thousand, which were respectively higher than （785.2 ±353.4） person - times, （18.9 ± 18.0） / per ten thousand, and （0. 2 ± 0. 1 ） / per ten thousand in the centers without the integrated health services （ P 〈 0.05 ）. The result of multiple regressions showed that the type of ownership had an effect on the number of per capita handled outpatient and emergency cases yearly, upward and downward referral rates. Conclusion The integrated health services have a promoting effect on raising outpatient and emergency service capability of community health service center, and establishing the upward and downward referral channels as well.

关 键 词：整合型医疗服务 社区卫生服务 举办主体 

分 类 号：R197[医药卫生—卫生事业管理]