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目的调查甘肃省临洮县新添中心卫生院基本情况,了解该院服务与经营现状,为乡镇卫生院药物配置、物流关键技术研究与产品开发提供基线数据。方法问卷调查结合专题访谈,内容包括一般情况、人员、经营及业务状况、基本药物目录实施情况等。结果①甘肃省临洮县新添中心卫生院硬件条件不够完善,受制于该县和省财政严重入不敷出。②该院医护比、医药比、医检比分别高于、略低于和等于全国平均水平,医技人员仅1人。全院69名员工中27.5%未达大专水平,81%是初级及以下职称;近2年分配入医护人员26名,流出1人。③2009年卫生院床位使用率高于全国平均水平(109%vs.60.7%);平均住院日高于全国平均水平(6 vs.4.8天)。④2010年门急诊人次比2009年增加17.6%,住院人次减少17%。⑤2010年人均门诊费用增长23.5%,人均住院费用增长14.9%。⑥医院于2010年6月实行国家基本药物目录,现有药品总数767种,超过基本药物目录总数。结论①甘肃省临洮县新添中心卫生院作为西部基本型示范乡镇卫生院,承担了当地民众的大量健康保障服务。②甘肃省“选拔普通高校毕业生到乡镇卫生院工作”的相关政策保障了该院的人员补充,但尚须进一步加强基础建设,调整人员结构,提高员工学历和资质,提升卫生技术水平。③医院药品收入比重较大,门诊费用低于全国平均水平。完全实行基本药物零差价销售可能对医院经营造成较大影响,需及时足额补贴及配套政策才能维持现有卫生服务水平。同时应开展基本药物循证遴选、使用培训和指导,确保药物安全合理使用。
Objective To investigate the basic situation of Xintian Central Hospital in Lintao County, Gansu Province, understand the service and operation status of the hospital, and provide baseline data for the research on key technologies and product development of township hospitals. Methods Questionnaire combined with a special interview, including general conditions, personnel, business and business conditions, the implementation of essential medicines directory and so on. Results ①Lintian County, Gansu Province, Xintian Center Hospital hardware conditions are not perfect, subject to the county and the provincial finance seriously make ends meet. ② hospital medical ratio, medical ratio, medical examination were higher than, slightly lower than and equal to the national average, only one medical technician. 27.5% of the 69 employees in the hospital did not reach the level of tertiary education, 81% were junior and below titles, 26 were assigned to medical staff in the past two years, and 1 person was discharged. ③ The utilization rate of beds in health centers in 2009 was higher than the national average (109% vs.60.7%); the average length of stay was higher than the national average (6 vs.4.8 days). ④ The number of outpatient and emergency visits in 2010 increased by 17.6% over 2009 and the number of hospitalizations decreased by 17%. ⑤ The per capita outpatient service cost increased by 23.5% in 2010, and the per capita hospitalization expense increased by 14.9%. ⑥ The hospital implemented the national essential medicine list in June 2010, with a total of 767 existing medicines, exceeding the total number of basic medicine catalogs. Conclusion ① Xintian Central Hospital, Linqu County, Gansu Province, serves as a model basic western township health center and undertakes a large number of local people’s health protection services. ② Relevant policies of “selecting ordinary college graduates in township hospitals” in Gansu Province have ensured the supplement of staff in the hospital, but still need to further strengthen the infrastructure construction, adjust the personnel structure, improve the academic qualifications and qualifications of employees and improve the technical level of health . ③ hospital drugs a larger proportion of income, out-patient costs below the national average. The full implementation of zero-difference sales of essential drugs may have a significant impact on the operation of the hospital, and adequate and timely subsidies and supporting policies should be in place to maintain the existing level of health services. At the same time, we should carry out basic evidence-based drug selection, use training and guidance to ensure the safe and rational use of drugs.