论文部分内容阅读
目的:了解国内公立综合医院的急诊比例分布现状。方法:选取《中国二、三级医院医疗服务能力》基线调查中具有急诊比例的452所二级医院和149所三级医院进行分析。结果:国内急诊比例呈偏态分布,二级医院的中位数为7.26%,低于三级医院的8.11%(P=0.027)。无论二级医院还是三级医院,急诊比例在东中西部的比较都呈现出东部最高;二级医院的急诊比例北方高于南方(8.61%vs 6.04%,P<0.001),但是三级医院急诊比例在南北方之间差异没有统计学意义(P=0.170)。二甲医院急诊比例高于二乙医院(8.01%vs 5.66%,P<0.001);但是,三甲医院的急诊比例却明显低于三乙医院(7.75%vs 11.00%,P=0.032)。结论:国内公立综合医院的急诊比例成偏态分布且总体水平偏低,在不同区域之间存在不均衡,不同等级医院之间存在明显差异。建议未来进一步研究该指标在分级诊疗实施过程中的评价作用,并逐步制定出符合国情的急诊比例参考指标值,从而更好地推动和实现分级诊疗。
OBJECTIVE: To understand the distribution of emergency departments in public hospitals in China. Methods: 452 second-level hospitals and 149 third-level hospitals with emergency department in the baseline survey of medical service ability of China’s second and third level hospitals were selected for analysis. Results: The proportion of emergency departments in China was skewed. The median of secondary hospitals was 7.26%, lower than that of tertiary hospitals (P = 0.027). No matter in Grade II or Grade III hospitals, the proportion of emergency cases in the eastern, central and western regions all showed the highest in the east. The level of emergency in secondary hospitals was higher in the north than in the south (8.61% vs 6.04%, P <0.001) There was no significant difference in the proportion between north and south (P = 0.170). The emergency attendance of Grade A hospitals was higher than that of Grade II B hospitals (8.01% vs 5.66%, P <0.001). However, the emergency attendance of Grade A hospitals was significantly lower than that of Grade III hospitals (7.75% vs 11.00%, P = 0.032). Conclusions: The proportion of emergency departments in domestic public general hospitals is skewed and the overall level is low. There is imbalance between different regions, and there are significant differences among different levels of hospitals. It is suggested that further study should be conducted on the evaluation of the indicator in the implementation of grading diagnosis and treatment and gradually formulate the reference value of the emergency department in line with national conditions so as to better promote and realize the grading diagnosis and treatment.