论文部分内容阅读
目的:分析新医改前后农村住院可分流病种在县乡医疗机构的分布差异,重点探索卫生体系因素对农村住院可分流病种患者就医机构选择的影响并提出建议。方法:卡方检验和二分类logistic回归。结果:2011年农村住院可分流病种患者仍有75%在县级医疗机构诊治;影响住院可分流病种患者就医选择的个体特征因素包括性别、年龄和婚姻状况等;卫生体系因素包括住所到最近乡县机构距离之比、乡县住院病人人均医药费用之比、县乡住院病人人均补偿比之比、乡镇卫生院基本药物配备比例和乡县卫生人力综合素质评分之比。结论:建议通过实行家庭责任医生制度、利用乡镇卫生院地理和价格优势、优化乡镇卫生院岗位设置和岗位组合等措施达到合理分流的目标。
OBJECTIVE: To analyze the distribution differences of rural hospitalized shunt diseases in medical institutions in county and towns before and after the new medical reform, and to explore the influence of health system factors on the selection of medical institutions for rural inpatients with shunt diseases and make recommendations. Methods: Chi-square test and dichotomous logistic regression. Results: In 2011, 75% of rural residents with shunt diseases were still diagnosed and treated in county-level medical institutions. Individual characteristics that influenced the selection of hospitalized patients with shunt diseases included gender, age and marital status, etc. Health system factors included accommodation The ratio of the distance between the nearest township and county institutions, the ratio of per capita medical expenses of inpatients in townships and townships, the per capita compensation ratio of inpatients in county and township hospitals, the ratio of basic medicines in township hospitals and the comprehensive quality of health workers in townships and townships. Conclusion: It is suggested that the goal of reasonable diversion should be achieved through the implementation of family responsibility doctor system, the use of township hospitals geographic and price advantages, the optimization of post settings and post combinations of township hospitals.