安徽省乡镇卫生院胃肠道疾病患者门诊诊疗服务评价与分析  

Evaluation and analysis of outpatient services for patients with gastrointestinal diseases in township health centers in Anhui province

作　　者：徐佳 杨宁静 杨鑫 崔恩慈 马晓燕 刘荣 沈兴蓉 王德斌[1,2] XU Jia;YANG Ningjing;YANG Xin;CUI Enci;MA Xiaoyan;LIU Rong;SHEN Xingrong;WANG Debin(School of Health Management,Anhui Medical University,Hefei 230032,China;Appropriate TechnologyCenter for Health Service and Health Management,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学卫生管理学院,合肥230032 [2]安徽医科大学卫生服务与健康管理适宜技术中心,合肥230032

出　　处：《济宁医学院学报》2024年第6期501-506,共6页Journal of Jining Medical University

基　　金：国家自然科学基金项目(81861138049);安徽省教育厅人文社科重点项目(2022AH050622)。

摘　　要：目的调查分析安徽省乡镇卫生院以胃肠道疾病为代表的常见病诊疗服务质量现状。方法采用多阶段抽样,随机抽取安徽省北部40个乡镇卫生院为调查点。将2022年7月1日至2022年8月1日所有前来卫生院就诊的胃肠道疾病患者纳入研究范围,依据相关指南制定胃肠道疾病诊疗过程观察条目。采用非参与观察法收集胃肠道疾病患者诊疗过程数据,采用面对面问卷调查收集就诊患者、门诊医生和卫生院相关信息。通过描述性分析评价胃肠道疾病诊疗服务质量,通过非参数检验和logistic回归分析探索诊疗服务质量影响因素。结果在309位纳入研究的患者中,女性患者略多于男性,年龄(54.35±17.70)岁,文化程度较低。胃肠道疾病诊疗服务总评分为(2.61±1.22)分。非参数检验结果显示,医生的资质、卫生院服务人口、床位数和医生数量影响诊疗服务质量评分(P<0.05)。多因素回归分析显示,47岁以上医生的诊疗服务总评分低于44岁以下的医生(OR=0.14,95%CI=0.03~0.72),服务人口多的卫生院诊疗服务总评分高于人口少的卫生院(OR=5.63,95%CI=1.46~21.79)。患者的性别、年龄、文化程度与诊疗服务评分未见有统计学显著意义的关联。结论乡镇卫生院胃肠道患者门诊诊疗服务评分较低,改善服务质量需要在重点关注医生和卫生院的监管与开发的同时,加强患者的宣传与教育以促进其积极参与诊疗决策。Objective To investigate and analyze the status quo of diagnosis and treatment quality of common diseases using the example of gastrointestinal diseases in township health centers in Anhui province.Methods A total of 40 township health centers in north Anhui province were selected as the study sites using multi-stage randomly sampling.All patients with gastrointestinal diseases who came to the site health centers from July 1,2022 to August 1,2022 were included in the survey,according to relevant guidelines,observation items on the diagnosis and treatment process of gastrointestinal diseases were formulated.Non-participative observation was used to collect data about diagnosis and treatment procedures,and face-to-face interviews were used to collect information of patients,outpatients and health centers.The quality of diagnosis and treatment of gastrointestinal diseases was evaluated by descriptive analysis,and the influencing factors were explored by non-parametric test and logistic regression analysis.Results Among the 309 patients recruited,female patients slightly over counted male patients.They aged 54.35 years on average.Their education level was low.The diagnosis and treatment service quality scored only 2.61±1.22.Non-parametric test results showed that the qualification of doctors,the service population of hospitals,the number of beds and the number of doctors affected the score of diagnosis and treatment service quality(P<0.05).Multivariate regression analysis showed that doctors aged<44 years scored higher than those aged>47 years(OR=0.14,95%CI=0.03~0.72),and the total score of medical services of hospitals with large population was higher than that of those with small population(OR=5.63,95%CI=1.46~21.79).The associations between the total quality score and the patients′sex,age and education were tested without statistical significance(P<0.05).Conclusion The score of outpatient service for gastrointestinal patients in township health centers was low.Future efforts in improving the service quality shou

关 键 词：胃肠道 乡镇卫生院 诊疗质量 

分 类 号：R193[医药卫生—卫生事业管理]