贵州省部分县级公立医院2013-2015年新农合住院疾病分析  

Analysis of New Rural Cooperative Disease in Some County-level Public Hospitals in Guizhou Province from 2013 to 2015

作　　者：张侨[1] 宋沈超 付东 ZHANG Qiao, SONG Shenchao, FU Dong(Department of Preventive Medicine in School of Public Health of Guizhou Medical University, Guiyang 550025, Guizhou, Chin)

机构地区：[1]贵州医科大学 [2]贵州医科大学公共卫生学院预防医学教研室,贵州贵阳550025

出　　处：《贵州医科大学学报》2018年第3期289-293,共5页Journal of Guizhou Medical University

基　　金：贵州省科技厅基金项目[黔科合LG字(2012)020号]

摘　　要：目的:通过分析贵州省部分县级公立医院新农合住院疾病及患者流向,为县级医院诊疗能力建设提供依据。方法:从贵州省88个县中随机抽取7个县作为研究点,从各县农合办信息系统提取2013-2015年所有新农合报销的疾病信息,依照住院病人诊断ICD编码(以国际ICD-10为分类标准)进行疾病分类,并对疾病构成及流向进行分析;根据患者就诊的医疗机构,将住院疾病分为县内和县外2部分,统计3年县内、县外住院患者分布情况;并将流向县外的住院病案与收集的诊疗能力表合并,得到县内对于流向县外疾病的能治与不能治情况;再将90%的县内能诊疗、但流向县外的患者作为吸引回流,得到理想状态下县内、外住院患者分布情况。结果:2013-2015年7个研究点流向县外医疗机构住院的人次数逐年增长,平均增长率为4.81%;且3年间,县内能够治疗、但流向县外的患者人次数呈现逐年增加的趋势;流向县外患者的疾病中约61%在县内能够诊疗,以分娩为首位;县内不能诊疗且外转率较高的疾病以肿瘤、脑血管疾病为主。结论:积极引导患者合理就医,加强县级公立医院妇科、肿瘤、心脑血管疾病能力建设,有利于县级新农合住院病人流向合理。Objective： To analyzethe hospitalized diseases and patient flow in some county-level public hospitals in Guizhou Province and provide the basis for building the diagnosis and treatment capacity of county-level hospitals. Methods： From 88 counties of Guizhou Province,7 counties were randomly selected as the research areas,and all the diseases information of the new rural cooperation for 2013-2015 years were extracted from the information system of the agricultural cooperation in each county.According to the ICD code of inpatient diagnosis（ international ICD-10 as the classification standard）,the disease classification was carried out,and the constitution and direction of disease were analyzed.According to the medical institutions of the patients,the hospitalized diseases were divided into two parts of the county and outside the county,and the distribution of inpatients was counted in the county and outside the county during the 3 year period. The hospitalized medical records out of the county and the collection of diagnosis and treatment ability table were merged to get the treatment and non treatment of disease in the county. 90 % counties were diagnosed and treated,but the patients outside the county can be used as suction reflux. The distribution of patients in the county and outside the hospital was under the ideal state. Results： The number of hospitalizations in the study areas outside the county increased year by year from 2013 to 2015,with an average growth rate of 4. 81%. During the past three years,the county was improved,but the number of patients outside the county increased year by year. About 61 % patients who went to the outside county were diagnosed and treated in the county to give birth to the first place. Cancer and cerebrovascular diseases were the main diseases that were diagnosed and treated in county. Conclusion： It is beneficial to the rational treatment of the patients in the county-level public hospitals,and the capacity construction of gynecology,tumour as well as cardiovascu

关 键 词：县医院 公立 医院 县 新农合 住院病人 患者分级医疗 患者流向 诊疗能力 贵州 

分 类 号：R197.3[医药卫生—卫生事业管理]