文章摘要
朱家斌,高 健,李玉峰,冷明祥.江苏省淮安市医疗机构老龄患者分级诊疗研究[J].南京医科大学学报(社会科学版),2016,(5):355~359
江苏省淮安市医疗机构老龄患者分级诊疗研究
The status quo of classification of diagnosis and treatment of elderly patients in medical institutions of Huai’an city
投稿时间:2016-05-31  
DOI:10.7655/NYDXBSS20160504
中文关键词: 分级诊疗  老年患者  淮安市
英文关键词: classification of diagnosis and treatment  elderly patients  Huai’an city
基金项目:江苏省哲学社会科学基金项目“福利多元视角下的社会服务支持体系研究”(14JSHB001)
作者单位
朱家斌 南京医科大学公共卫生学院,江苏 南京 211166
南京医科大学附属淮安一院,江苏 淮安 223300 
高 健 南京医科大学附属淮安一院,江苏 淮安 223300 
李玉峰 南京医科大学附属淮安一院,江苏 淮安 223300 
冷明祥 南京医科大学公共卫生学院,江苏 南京 211166 
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中文摘要:
      目的:了解江苏省淮安市医疗机构老年患者分级诊疗的现状并探索如何科学地落实分级诊疗?方法:抽样调查2014年和2015年江苏省淮安市某三甲医院及基层医疗机构65岁以上老年患者的就诊资料,分析并比较其前二十种疾病主要诊断及费用等情况?结果:三甲医院收治的老年患者病种主要集中在肿瘤(含放化疗)及心脑血管两大类疾病上,基层医疗机构则以心脑血管疾病为主;三甲医院收治的老年患者的主要病种及住院费用较为稳定,基层医疗机构的平均住院费用约为三甲医院的三分之一,且不同病种间平均住院费用变化不大?结论:三级医院收治的主要病种构成及其费用变化不大,应提高疑难危重病例收治比例;基层医疗机构收治老年慢性病患者比例明显有所提高,还需进一步加强基层首诊制的落实;增强对老年患者的宣教,灌输分级诊疗的就医理念,引导患者有序就医?
英文摘要:
      Objective: To understand the status quo of the classification of diagnosis and treatment of elderly patients in medical institutions of Huai’an City, and explore how to scientifically implement the classification of diagnosis and treatment. Methods: We sampling-surveyed medical information of elderly patients (aged over 65 years old) from a tertiary referral center and primary care institutions in Huai’an City from 2014 to 2015. The top-20 diseases of main diagnosis and cost were analyzed and compared. Results: Disease types of elderly patients in the tertiary referral center were mainly concentrated in the tumor (including chemotherapy) and cardiovascular and cerebrovascular diseases, and those in the primary care institutions were cardiovascular and cerebrovascular diseases. Furthermore, the main diseases and hospitalization expenses of the elderly patients admitted to the tertiary hospitals were relatively stable. The average hospitalization expenses of the primary care institutions were approximately 1/3 of the tertiary referral center, and the average hospitalization expenses among different types of diseases had little change. Conclusion: The main types of diseases and their treatment costs in the tertiary hospital were not changed, and the proportion of difficult and critical cases should be improved; The proportion of elderly chronic diseases in primary care institutions was significantly improved, but the implementation of the first diagnosis system need to be further strengthened; The propaganda should be enhanced in elderly patients, and the concept of classification of diagnosis and treatment need to be instilled to guide patients in an orderly manner to seek medical treatment.
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