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目的通过对新疆县乡镇医院住院病人疾病构成、患者医疗费用等情况的分析,掌握基层住院患者医疗负担和医疗单位对医疗服务技术的需求情况。方法选择新疆阜康市(县级市)、福海县、洛浦县、富蕴县作为样本县市。调查员以病案号随机抽取各县市县医院、乡镇卫生院2008年1月1日-12月31日期间全部住院病案的1/12作为调查对象。由调查员按照要求统一填写调查表。结果 (1)县级医院排在前五位的系统疾病依次为:妊娠、分娩和产褥期疾病、循环系统疾病、呼吸系统疾病、消化系统疾病、损伤和中毒;乡镇医院前五位系统疾病依次为:呼吸系统疾病、循环系统疾病、消化系统疾病、泌尿生殖系统疾病、妊娠、分娩和产褥期疾病。(2)妊娠、分娩和产褥期疾病、循环系统疾病、呼吸系统疾病、消化系统疾病、损伤和中毒、泌尿生殖系统六大类系统性疾病患者的平均住院天数在县、乡两级医院分别为:7.56、10.27、8.73、8.63、10.14、8.87 vs 2.49、9.06、6.82、5.14、7.22、7.94。(3)急慢性支气管炎、高血压、脑梗死、胃肠炎、阑尾炎、宫颈炎和肺炎疾病患者住院费用的中位数(元)在县、乡两级医院分别为:1164.33、2325.00、1861.80、1078.66、1986.61、1824.82、942.12 vs 429.18、649.95、492.63、274.27、1229.05、771.05、481.00。结论新疆县、乡镇两级医院住院患者的疾病构成不同,且同一病种的县级医院住院患者的费用高于乡镇级医院住院患者。
Objective To analyze the disease composition of inpatients and the medical expenses of patients in township hospitals in Xinjiang, and to understand the medical burden of patients in primary hospitals and the demand for medical services by medical units. Methods Fukang, Xinjiang (county-level cities), Fuhai County, Luopu County and Fuyun County were selected as the sample cities and counties. The investigators randomly selected 1/12 of the total inpatient medical records of all counties, cities and counties and township hospitals from January 1, 2008 to December 31, 2008 as the survey subjects. The investigators should fill in the questionnaire according to the requirements. Results (1) The top five system diseases in county-level hospitals were as follows: pregnancy, childbirth and puerperium, circulatory diseases, respiratory diseases, digestive diseases, injuries and poisoning; the top five diseases of township hospitals were : Respiratory system diseases, circulatory system diseases, digestive system diseases, genitourinary system diseases, pregnancy, childbirth and puerperium diseases. (2) The average length of stay of patients in the six major categories of systemic diseases such as pregnancy, childbirth and puerperium, circulatory system diseases, respiratory system diseases, digestive system diseases, injuries and poisonings, genitourinary system are as follows: 7.56, 10.27, 8.73, 8.63, 10.14, 8.87 vs 2.49, 9.06, 6.82, 5.14, 7.22, 7.94. (3) Median Hospitalization Expenses for Patients with Acute and Chronic Bronchitis, Hypertension, Cerebral Infarction, Gastroenteritis, Appendicitis, Cervicitis and Pneumonia (yuan) At the county and township level, hospitals are respectively 1164.33, 2325.00 and 1861.80 , 1078.66, 1986.61, 1824.82, 942.12 vs 429.18, 649.95, 492.63, 274.27, 1229.05, 771.05, 481.00. Conclusions The inpatients in the two counties in Xinjiang and the township have different disease constitutions, and the cost of inpatients in county-level hospitals of the same disease is higher than those in township-level hospitals.