中华医院管理杂志
中華醫院管理雜誌
중화의원관리잡지
CHINESE JOURNAL OF HOSPITAL ADMINISTRATION
2015年
4期
279-282
,共4页
高晓娜%陈迎春%储召群%张丽晶
高曉娜%陳迎春%儲召群%張麗晶
고효나%진영춘%저소군%장려정
新型农村合作医疗%老年人%住院服务过度需求%特征%原因
新型農村閤作醫療%老年人%住院服務過度需求%特徵%原因
신형농촌합작의료%노년인%주원복무과도수구%특정%원인
New Rural Cooperative Medical%Elderly people%Excessive demand for inpatient service%Characteristics%Reasons
目的：了解新型农村合作医疗老年人住院服务过度需求现状，总结特征并分析影响老年人住院服务过度需求的原因，为农村卫生服务的合理利用提供启示和帮助。方法随机抽取县乡两级医疗机构2012年老年人住院病历1665份，在此基础上入户调查老年人135例，比较其入院合理性差异。结果新型农村合作医疗县级医疗机构老年人不合理入院率为14.29%，乡镇卫生院老年人不合理入院率为30.10%；县级医疗机构内科、外科、其他科室的老年人不合理入院率分别为17.65%、10.38%、9.49%，乡镇卫生院内科、外科、其他科室的老年人不合理入院率分别为31.98%、19.77%、45.83%；县级医疗机构循环系统、骨骼肌肉类、外伤中毒类老年人不合理入院率分别为20.55%、24.00%、4.76%，乡镇卫生院循环系统、骨骼肌肉类、外伤中毒类老年人不合理入院率分别为35.69%、44.74%、10.91%；老年人入院合理性在生活状态、身体状况、新型农村合作医疗补偿及入院决策人等方面不同。结论减少老年人住院服务过度需求，从服务体系、保障体系和社会支持3个方面分析原因并提出有效控制措施，以期切实解决好农村老年人的住院合理性问题以及由此反映出的各种社会问题。
目的：瞭解新型農村閤作醫療老年人住院服務過度需求現狀，總結特徵併分析影響老年人住院服務過度需求的原因，為農村衛生服務的閤理利用提供啟示和幫助。方法隨機抽取縣鄉兩級醫療機構2012年老年人住院病歷1665份，在此基礎上入戶調查老年人135例，比較其入院閤理性差異。結果新型農村閤作醫療縣級醫療機構老年人不閤理入院率為14.29%，鄉鎮衛生院老年人不閤理入院率為30.10%；縣級醫療機構內科、外科、其他科室的老年人不閤理入院率分彆為17.65%、10.38%、9.49%，鄉鎮衛生院內科、外科、其他科室的老年人不閤理入院率分彆為31.98%、19.77%、45.83%；縣級醫療機構循環繫統、骨骼肌肉類、外傷中毒類老年人不閤理入院率分彆為20.55%、24.00%、4.76%，鄉鎮衛生院循環繫統、骨骼肌肉類、外傷中毒類老年人不閤理入院率分彆為35.69%、44.74%、10.91%；老年人入院閤理性在生活狀態、身體狀況、新型農村閤作醫療補償及入院決策人等方麵不同。結論減少老年人住院服務過度需求，從服務體繫、保障體繫和社會支持3箇方麵分析原因併提齣有效控製措施，以期切實解決好農村老年人的住院閤理性問題以及由此反映齣的各種社會問題。
목적：료해신형농촌합작의료노년인주원복무과도수구현상，총결특정병분석영향노년인주원복무과도수구적원인，위농촌위생복무적합리이용제공계시화방조。방법수궤추취현향량급의료궤구2012년노년인주원병력1665빈，재차기출상입호조사노년인135례，비교기입원합이성차이。결과신형농촌합작의료현급의료궤구노년인불합리입원솔위14.29%，향진위생원노년인불합리입원솔위30.10%；현급의료궤구내과、외과、기타과실적노년인불합리입원솔분별위17.65%、10.38%、9.49%，향진위생원내과、외과、기타과실적노년인불합리입원솔분별위31.98%、19.77%、45.83%；현급의료궤구순배계통、골격기육류、외상중독류노년인불합리입원솔분별위20.55%、24.00%、4.76%，향진위생원순배계통、골격기육류、외상중독류노년인불합리입원솔분별위35.69%、44.74%、10.91%；노년인입원합이성재생활상태、신체상황、신형농촌합작의료보상급입원결책인등방면불동。결론감소노년인주원복무과도수구，종복무체계、보장체계화사회지지3개방면분석원인병제출유효공제조시，이기절실해결호농촌노년인적주원합이성문제이급유차반영출적각충사회문제。
Objective Understanding the current elderly people’s excessive demand for inpatient services under NRCMS,summarizing characteristics and analyzing causes so to provide inspiration and support for the rational use of health services in rural areas.Methods 1 665 medical records of seniors were randomly selected from medical institutions of county and township levels in 2012.Based on such data,135 household surveys were made,comparing the reasonableness of their hospitalization.Results The unreasonable rate at county level is 14.29%,and 30.10% at township hospitals;The unreasonable rate of internal medicine,surgery and other sections at county level hospital are 1 7.65%、10.38%、9.49%,the unreasonable hospitalization rate of internal medicine,surgery and other sections at township hospitals are 31.98%, 1 9.77%,and 45.83% respectively;The unreasonable hospitalization rate of circulatory system,skeletal muscle type,injury and poison at county level hospital are 20.55%、24.00%、4.76%,the unreasonable rate of the circulatory system,skeletal muscle type,injury and poison at township hospitals are 35.69%,44.74%and 10.91%respectively.Elderly people’s excessive demand for inpatient services varies with their living condition,physical condition,the NCMS compensation policy and other factors.Conclusion To reduce the excessive demand,we put forward effective control measures from the service system,security system and social support,so as to effectively meet reasonable hospitalization demands in rural areas and social problems so incurred.
