广东省县域内住院率变化趋势及影响因素分析  

The analysis of the change trend and influencing factors of hospitalization rate in counties of guangdong province

作　　者：齐奕 杨业春[3] 孔抗美 QI Yi;YANG Yechun;KONG Kangmei(Business School,University Institute of Lisbon,Lisbon 1649-026,Portugal;School of Health Management,Southern Medical University,Guangzhou 510180,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangdong Institute of Modern Hospital Management,Guangzhou 510110,China)

机构地区：[1]里斯本大学学院商学院 [2]南方医科大学卫生管理学院,广东广州510180 [3]广州中医药大学第一附属医院,广东广州510405 [4]广东现代医院管理研究所,广东广州510110

出　　处：《现代医院》2022年第4期497-500,共4页Modern Hospitals

基　　金：2021年广东省医改办决策咨询研究项目;2020年度广东省医学科研基金指令性课题(C2020085)。

摘　　要：目的通过分析广东省57个县(市)县域内住院率现状及变化趋势,对县域内住院率的影响因素进行探讨,为县(市)提升医疗服务能力,实现分级诊疗的医改目标提供参考依据。方法通过描述广东省57个县(市)医改前后县域内住院率的变化情况,进一步从卫生基层设施、卫生人力资源、医疗服务总量和医疗服务效率四个维度分析影响县域内住院率的因素。结果2020年广东省县域内住院率为85.3%,较2015年上升5.5个百分点。57个县(市)中有10个县域内住院率超过90%,其中县域内住院率最高的是高州市达96.5%。与2015年相比,县域内住院率年平均增长速度最快的是南澳县,县域内住院率从34.9%提升至61.1%。县域内住院率受每千人床位数(OR=1.966)、每万人出院人次(OR=1.004)和病床使用率(OR=1.075)的影响(P<0.05)。结论广东省应用县域内住院率指标作为医改指标,以考核县域内住院率为总抓手,以点带面,通过多种途径引进和培养卫生技术人才,依托紧密型医联体和搭建区域卫生信息化共享平台,提升医疗服务能力,有效推动了县域内医疗卫生服务供给侧改革。Objective By analyzing the current situation and change trend of hospitalization rate in 57 counties(cities)of Guangdong Province,this paper discusses the influencing factors of hospitalization rate in counties,and provides reference for counties(cities)to improve their medical service capacity and achieve the goal of medical reform in tiered diagnosis and treatment model.Methods By describing the changes of hospitalization rate in 57 counties(cities)of Guangdong Province before and after medical reform,this paper further analyzes the factors affecting hospitalization rate in counties from four dimensions:the primary-level health facilities,health human resources,total medical services and medical service efficiency.Results In 2020,the hospitalization rate in counties of Guangdong Province was 85.3%,up by 5.5 percentage points from 2015.In 10 of 57 counties(cities),the hospitalization rate exceeded 90%.The county(city)with the highest hospitalization rate is Gaozhou(96.5%);compared with 2015,Nan’ao County has the fastest annual average growth rate of hospitalization rate,and the hospitalization rate in the county has increased from 34.9% to 61.1%.The hospitalization rate was affected by the number of beds per thousand people(OR=1.966),the number of discharged patients per ten thousand people(OR=1.004)and the utilization rate of beds(OR=1.075)(P<0.05).Conclusion Guangdong Province,by applying the index of hospitalization rate in counties as the index of medical reform,taking the assessment of hospitalization rate in counties as the overall starting point,introducing and training health workers working at the primary level through various channels,relying on close medical associations and building a regional health information sharing platform,has improved medical service capabilities and effectively promoted the supply-side reform of medical and health services in counties.

关 键 词：分级诊疗 县域内住院率 影响因素 医联体 

分 类 号：R197[医药卫生—卫生事业管理]