[1]郭昱君郑振佺杜芳邱亨嘉.应用可避免住院疾病指标评价基层医疗服务质量[J].中国卫生质量管理,2021,28(09):046-50.[doi:10.13912/j.cnki.chqm.2021.28.9.13 ]
 GUO Yujun,ZHENG Zhenquan,DU Fang.To Evaluate the Quality of Primary Medical Service by Using Indicators of Ambulatory Care Sensitivity Conditions[J].Chinese Health Quality Management,2021,28(09):046-50.[doi:10.13912/j.cnki.chqm.2021.28.9.13 ]
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应用可避免住院疾病指标评价基层医疗服务质量
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年09期
页码:
046-50
栏目:
服务质量
出版日期:
2021-09-28

文章信息/Info

Title:
To Evaluate the Quality of Primary Medical Service by Using Indicators of Ambulatory Care Sensitivity Conditions
作者:
郭昱君郑振佺杜芳邱亨嘉
福建医科大学卫生健康研究院
Author(s):
GUO YujunZHENG ZhenquanDU Fang
Health Research Institute, Fujian Medical University
关键词:
可避免住院院外服务敏感疾病医共体服务质量
Keywords:
Avoidable Hospitalization Ambulatory Care Sensitivity Conditions (ACSCs) Medical Alliance Service Quality
分类号:
R197.6
DOI:
10.13912/j.cnki.chqm.2021.28.9.13
文献标志码:
A
摘要:
目的应用院外服务敏感疾病(ACSCs)指标探讨医共体常见的可避免住院疾病,评价基层医疗服务质量,提出针对性改进建议。方法分析福建省某县域医共体牵头医院的病案数据。分析变量是NHS-ACSCs各指标的住院比例,其他变量包含患者人口学特征以及合并症情况。采用SAS 9.3版软件进行统计分析。结果前十位常见ACSCs住院疾病依次是流感和肺炎、慢性阻塞性肺疾病、耳鼻喉感染、脱水和肠胃炎、充血性心力衰竭、高血压、痉挛和癫痫、心绞痛、糖尿病并发症、气喘。ACSCs住院与患者年龄、合并症情况显著相关。结论应用ACSCs评估医共体基层服务质量时,应根据不同年龄群体选择合适指标,以增加ACSCs的敏感度。
Abstract:
ObjectiveTo apply Ambulatory Care Sensitivity Conditions (ACSCs) indicators to assess the common avoidable hospitalization diseases in a medical alliance, evaluate the quality of primary medical services and put forward relevant suggestions for improvement.MethodsThe medical record data of the leading hospital of a county medical community in Fujian Province was analyzed. The analysis variable was the hospitalization rate of each ACSCs indicator, and other variables included patient demographic characteristics and comorbidity. The SAS 9.3 software was used for statistical analysis.ResultsThe top 10 most common ACSCs hospitalizations were influenza and pneumonia, chronic obstructive pulmonary disease, ear, nose and throat infection, dehydration and gastroenteritis, congestive heart failure, hypertension, seizures, angina, diabetic complications, and asthma. ACSCs hospitalization was significantly correlated with age and comorbidities of patients.Conclusion When using ACSCs to evaluate the quality of service at the primary level of the medical alliance, appropriate indicators should be selected according to different age groups to increase the sensitivity of ACSCs.

参考文献/References:

[1]周传坤, 曲 直, 马 雯, 等.可避免住院: 概念和意义[J].中国卫生质量管理,2015, 22(6):18-22. [2]Cheng SH, Chen CC, Hou YF. A longitudinal examination of continuity of care and avoidable hospitalization: evidence from a universal coverage health care system[J].Archives of Internal Medicine,2010, 170(18):1671-1677. [3]Kim H, Cheng SH. Assessing quality of primary diabetes care in South Korea and Taiwan using avoidable hospitalizations[J].Health Policy, 2018, 122(11):1222-1231. [4]Burgdorf F, Sundmacher L. Potentially avoidable hospital admissions in Germany: an analysis of factors influencing rates of ambulatory care sensitive hospitalizations[J].Deutsches rzteblatt International,2014, 111(13):215. [5]Chen T,Pan J. The effect of spatial access to primary care on potentially avoidable hospitalizations of the elderly: evidence from Chishui city, China[Z]. 2020. [6]Jackson G, Tobias M. Potentially avoidable hospitalisations in New Zealand, 1989–98[J].Australian and New Zealand Journal of Public Health, 2001, 25(3):212-221. [7]Purdy S, Griffin T, Salisbury C, et al. Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians[J].Public Health, 2009, 123(2):169-173. [8]Caminal J, Starfield B, Sánchez E, et al. The role of primary care in preventing ambulatory care sensitive conditions[J].The European Journal of Public Health,2004, 14(3):246-251. [9]周传坤, 马谢民, 赵乐. 可避免住院:可避免再住院研究概述[J].中国医院管理,2018, 38(6):12-14. [10]柴培培, 张毓辉, 万泉, 等. 基于卫生费用核算的我国慢性病可避免住院费用分析[J].中国卫生经济,2019, 38(4):13-16. [11]李飞成, 简伟研, 孙美平. 农村居民糖尿病可避免住院研究[J].中国全科医学,2019, 22(22):2735-2738. [12]周传坤, 马谢民, 赵乐. 北京地区3所综合医院可避免住院研究[J].中国医院管理,2018, 38(6):15-17. [13]李克强. 把保基本强基层建机制作为医改工作的重心[J].新华文摘, 2010(23):1-4. [14]杨坚, 卢珊, 金晶, 等. 基于系统思想的分级诊疗分析[J].中国医院管理,2016, 36(1):1-5. [15]雷光和, 王娜. 从强基层角度推进分级诊疗的探讨[J].中国全科医学 2017, 20(16):1925-1928. [16]蒋祥, 王芳, 田淼淼, 等. 县域医共体背景下安徽省定远县家庭医生签约服务进展分析[J].中国卫生政策研究,2019, 12(4):50-55. [17]赵敏捷, 贾 梦, 王 芳, 等. 浙江省德清县县域医共体改革措施与效果分析[J].中国卫生政策研究,2019, 12(11):53-58. [18]李岚兰, 汤质如, 颜理伦, 等. 安徽省县域医共体运行现状调查分析[J].中国卫生事业管理,2018, 35(10):723-725. [19]Sundararajan V, Henderson T, Perry C, et al. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality[J].Journal of Clinical Epidemiology,2004, 57(12):1288-1294. [20]Renner AT. Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria[J]. Eur J Health Econ,2020, 21(1):85-104. [21]Zucco R, Pileggi C, Vancheri M, et al. Preventable pediatric hospitalizations and access to primary health care in Italy[J].PloS One,2019, 14(10):e0221852. [22]McDarby G, Smyth B. Identifying priorities for primary care investment in Ireland through a population-based analysis of avoidable hospital admissions for ambulatory care sensitive conditions (ACSC)[J].BMJ,2019, 9(11):e028744.

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更新日期/Last Update: 2021-09-28