深圳市社区卫生服务中心家庭医生签约居民门诊中医疾病谱分析  

Traditional Chinese Medicine Disease Spectrum Analysis in Outpatient Clinics of Contracted Residents by Family Doctors in Shenzhen Community Health Service Centers

作　　者：尹朝霞 孔憧宇 邹先辉 李创 黄茵 冯阳 王云飞 公为洁 YIN Zhaoxia;KONG Chongyu;ZOU Xianhui;LI Chuang;HUANG Yin;FENG Yang;WANG Yunfei;GONG Weijie(Department of Family Medicine,Shenzhen University Health Science Center,Shenzhen 518073,China;Youjiang Medical University for Nationalities,Baise 533000,China;Department of Community Health,Shenzhen Municipal Health Commission,Shenzhen 518038,China;Shenzhen Health Development Research and Data Management Center,Shenzhen 518106,China)

机构地区：[1]深圳大学医学部全科医学系,广东省深圳市518073 [2]右江民族医学院,广西壮族自治区百色市533000 [3]广东省深圳市卫生健康委员会基层卫生健康处,518038 [4]广东省深圳市卫生健康发展研究和数据管理中心,518106

出　　处：《中国全科医学》2023年第25期3112-3117,3126,共7页Chinese General Practice

基　　金：深圳市卫生健康委员会委托项目。

摘　　要：背景中医药发展已被列为国家发展战略,大力提升基层医疗卫生机构的中医药服务能力是其中的重要内容之一,但目前鲜有针对社区卫生服务机构中医药诊疗疾病谱的研究。目的分析深圳市社区健康服务中心(简称社康中心)家庭医生签约居民门诊就诊的中医诊疗疾病谱,以了解深圳市社康中心的中医药诊疗能力,为推动我国基层中医药事业发展提供理论依据。方法于2022年5—6月,从深圳市卫生健康委员会统一信息平台“杭创社区健康服务中心业务系统”中提取2021-01-01至2021-06-30家庭医生签约居民在深圳市10个区社康中心门诊就诊且产生诊疗费用的记录,选取以中医诊疗为就诊目的、产生相匹配诊疗费用、第一诊断为《中医病证分类与代码》(TCD)编码诊断的诊疗记录纳入研究(n=385138)。基于TCD中的病名分类对疾病谱进行分析,主要涉及科别类目、专科系统分类目、中医疾病名称。结果纳入的385138条诊疗记录中,男170077人次(44.16%),平均年龄(37.5±8.2)岁;女215061人次(55.84%),平均年龄(36.7±9.4)岁。疾病谱涵盖TCD所有7个科别类目,依次为:内科219445条(56.98%)、儿科79201条(20.56%)、耳鼻喉科47965条(12.45%)、妇科30620条(7.95%)、外科5797条(1.51%)、骨伤科1407条(0.37%)、眼科703条(0.18%)。除各科别类目中瘤病类、癌病类,眼科中眦病类、黑睛病类、瞳神病类、外伤眼病类外,疾病谱涵盖7个科别类目下的所有专科系统分类目。各科别类目下,数个疾病谱累计诊疗量占据该科别类目≥90.00%总诊疗量。疾病谱排名前5位系统疾病分别为呼吸系统疾病208701条(54.19%)、肌肉骨骼系统疾病73369条(19.05%)、妇科系统疾病30620条(7.95%)、心脑血管系统疾病27539条(7.15%)、消化系统疾病19162条(4.98%)。<15岁和15~24岁患者以与呼吸道、消化道有关的疾病为主,随着年龄的增长,痹病、眩晕病、头痛病、不寐病、乏�Background The development of traditional Chinese medicine(TCM) has been listed as a national development strategy with vigorous improvement of TCM service capacity in primary care institutions as the important elements,however,there are few studies on the disease spectrum of TCM in community health service institutions.Objective To analysis the TCM disease spectrum in outpatient clinics of contracted residents by family doctors in Shenzhen community health service centers(abbreviated as CHSC) and understand the capability of TCM in Shenzhen health centers,thus providing a theoretical basis for promoting the development of TCM in primary care in China.Methods From May to June 2022,the records of outpatient consultations with treatment cost of 10 Shenzhen CHSCs from 2021-01-01 to 2021-06-30 were extracted by the unified information platform of the Health Commission of Shenzhen Municipality(Hangchuang Community Health Service Center Business System).The 385 138 records with purpose of TCM treatment,matching diagnosis and treatment costs,first diagnosis can be coded in Classification and Codes of Diseases and ZHENG of Traditional Chinese Medicine(TCD) were collected.The disease spectrum was analyzed based on the classification of disease in TCD,mainly involving department categories,specialty system classifications,and TCM disease terms.Results A total of 385 138 records of TCM diagnosis and treatment were selected in this study,including 170 077(44.16%) male cases and 215 061(55.84%) female cases,with an average age of( 36.7±9.4) years.All of the 7 TCD categories of disease spectrum were involved,including internal medicine accounting for 56.98%(219 445 cases),pediatrics accounting for 20.56%(79 201 cases),otolaryngology accounting for 12.45%(47 965 cases),gynecology accounting for 7.95%(30 620 cases),surgery accounting for 1.51%(5 797 cases),orthopedics accounting for 0.37%(1 407 cases) and ophthalmology accounting for 0.18%(703 cases).Apart from the specialty system classifications of tumor diseases,cancer disea

关 键 词：社区卫生服务 中医诊疗 诊疗能力 中医病证分类与代码 疾病谱 家庭医生签约 

分 类 号：R197[医药卫生—卫生事业管理]