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目的调查成都市基层医疗机构基本医疗服务量现状及门诊量相关影响因素,为进一步提升基层服务量、推进分级医疗的实施提供参考。方法 2016年10月—11月采用普查方法,对成都市22个区(市)县所有基层医疗机构(共计390个社区卫生服务中心和乡镇卫生院)2015年度基本服务量情况进行调查,问卷由各调查对象自填。采用秩和检验、秩相关性分析、多重线性回归分析其门诊量影响因素。结果成都市2015年社区卫生服务中心和乡镇卫生院的全年门诊诊疗量中位数分别为60 493、31 374人次。社区卫生服务中心及乡镇卫生院医师日均诊疗人次中位数分别为14.41、13.29人次;社区卫生服务中心全科医师、康复医师、中医医师日均诊疗人次分别为12.22、10.10、4.82人次,乡镇卫生院上述指标分别为8.16、6.34、6.17人次。多因素分析显示社区卫生服务中心中级医师越多,门诊量越高(P<0.05)。乡镇卫生院中有口腔科的医疗机构比无口腔科的医疗机构门诊量高(P<0.05);初级医师越多,门诊量越高(P<0.05);病床数越多,门诊量越高(P<0.05);服务人口数越多,门诊量越高(P<0.05)。结论成都市基层医疗机构不同机构间服务量存在差异,还需进一步合理规划科室及人员建设,提高基层医疗服务量。
Objective To investigate the status quo of basic medical services and the influencing factors of outpatients in primary health care institutions in Chengdu, and to provide reference for further improving primary services and promoting the implementation of grading medical services. Methods From October to November of 2016, the census method was used to investigate the basic service volume of all basic medical institutions (total 390 community health centers and township health centers) in 22 districts (cities) in 2015 in Chengdu. The questionnaire was composed of The survey respondents self-filling. Rank sum test, rank correlation analysis and multiple linear regression were used to analyze the influencing factors of outpatient service. Results In 2015, the median annual outpatient clinic visits of CHS and township hospitals in Chengdu were 60 493 and 31 374 respectively. The daily average number of consultation visits by community health service centers and township hospital physicians was 14.41 and 13.29 respectively. The daily average number of visits by general practitioners, rehabilitation physicians and Chinese medicine practitioners in community health service centers was 12.22,10.10 and 4.82 respectively. The township Hospital above indicators were 8.16,6.34,6.17 passengers. Multivariate analysis showed that the more mid-level physicians in community health service centers, the higher the outpatient amount (P <0.05). The number of outpatients with stomatology in township hospitals was significantly higher than that without stomatology (P <0.05). The more primary doctors were, the higher the outpatients was (P <0.05). The more beds were, the higher the outpatients (P <0.05). The more service population, the higher the outpatient amount (P <0.05). Conclusion There are differences in the service volume among different agencies in primary health care institutions in Chengdu. It is necessary to further rationalize the construction of departments and personnel and improve the service volume of grassroots medical services.