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目的调查宁夏自治区吴忠市高闸镇中心卫生院的基本情况,了解该院服务与经营现状,为乡镇卫生院药物配置与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宁夏自治区吴忠市高闸镇中心卫生院硬件条件不够完善,服务人群人均收入低于吴忠市和全国平均水平。②医护比、医检比均低于全国平均水平,医技比略高于全国平均水平。各专业岗位人员数量不足,缺乏专业药剂人员,工勤人员与护理人员比重相等。卫生院3.4%的卫技人员无专业学历,38%未达大专水平;86.2%的员工是初级及以下职称;员工流动性差。③2009年卫生院床位使用率低于全国平均水平(46.4%vs.60.7%);平均住院日、医师日均诊疗负担和日均住院负担均高于全国平均水平(8 vs.4.8,9 vs.8.3,4 vs.1.3)。④2010年门急诊人次比2009年减少26.9%,住院人次减少42.4%。⑤2010年人均门诊费用增长127.3%,人均住院费用增长56.2%。⑥医院于2010年4月1日起使用国家基本药物目录(EML),药品总数195种,仅占EML总数的63.5%。结论宁夏自治区吴忠市高闸中心卫生院要达到西部全科型示范乡镇卫生院要求和服务标准,尚须进一步加强基础建设,增加卫生技术人员数量,调整人员结构,提高员工学历和资质,促进人员流动,提升卫生技术水平。医院药品收入控制较好,医药费用低于全国平均水平,2010年医药费用增长迅速。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,须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增选补充、使用培训和指导,确保药物安全合理使用。
Objective To investigate the basic situation of Gaozha Town Central Hospital of Wuzhong City, Ningxia Autonomous Region, understand the service and operation status of the hospital, and provide baseline data for the research and product development of key technologies and logistics 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 ① The hardware conditions of Gaozha Town Central Hospital in Wuzhong City, Ningxia Autonomous Region were not perfect enough. The per capita income of service people was lower than that of Wuzhong City and the national average. ② The ratio of medical care and medical examination were lower than the national average, medical technology slightly higher than the national average. The shortage of professional staff positions, the lack of specialized pharmacy staff, duty and nursing staff equal. 3.4% of the health centers have no professional qualifications, 38% have not reached the level of tertiary education; 86.2% of the staff are junior and below titles; and the staff’s mobility is poor. ③In 2009, the utilization rate of beds in health centers was lower than the national average (46.4% vs.60.7%); the average length of stay, the average daily physician burden and daily hospitalization burden were higher than the national average (8 vs.4.8,9 vs. 8.3,4 vs.1.3). ④ The number of outpatient and emergency visits in 2010 decreased by 26.9% over 2009 and the number of hospitalizations decreased by 42.4%. ⑤ Per capita outpatient expenses increased by 127.3% in 2010, and per capita hospitalization expenses increased by 56.2%. ⑥ Hospital from April 1, 2010 from the use of the national essential medicines directory (EML), the total number of 195 kinds of drugs, accounting for only 63.5% of the total number of EML. Conclusion High Gate Center Hospital of Wuzhong City, Ningxia Autonomous Region To meet the requirements and service standards of the model township hospitals in the western part of China, it is still necessary to further strengthen the infrastructure construction, increase the number of health technicians, adjust the staffing structure, improve the qualification and qualifications of employees, Flow, improve health technology. Hospital drug income control is better, medical expenses lower than the national average, the rapid growth of medical expenses in 2010. The full implementation of zero-difference sales of essential drugs may have a significant impact on the operation of hospitals. Sufficient subsidies and supporting policies must be in place to maintain the existing level of health services. At the same time, basic medicines should be supplemented by evidence-based additions, using training and instruction to ensure that drugs Safe and reasonable use.