北京市儿童先天性心脏病住院服务集中程度分析

汤淑女; 简伟研; 卢铭

引用本文：汤淑女,简伟研,卢铭.北京市儿童先天性心脏病住院服务集中程度分析[J].中国卫生政策研究,2013,6(1):46-50

北京市儿童先天性心脏病住院服务集中程度分析

投稿时间：2012-12-18 修订日期：2012-12-29 PDF全文浏览 HTML全文浏览

1.北京大学公共卫生学院;2.北京大学基础医学院

摘要:探索北京市儿童先天性心脏病住院服务的集中程度。方法：从北京市出院病人病案首页数据库中，提取2005—2010年因患先天性肺动脉瓣狭窄等4类先心病在北京地区医疗机构接受住院治疗并出院的全部儿童（0～14岁）病例，计算不同医院的市场份额，并采用Logistic回归和多重线性回归模型，对不同市场份额医疗机构的此类疾病住院服务绩效进行比较。结果：此类型的病例93%以上集中于3家医院。与其它医疗机构相比，份额高的医疗机构其治疗技术、质量较高，住院时间较短，住院费用的趋势不尽一致。结论与建议：在促进医院普遍开展儿科服务的政策基础上，应引导医疗机构结合自身优势确定发展方向和功能定位，形成具有一定规模的儿科诊疗服务。

关键词:儿童先天性心脏病住院服务集中程度

基金项目:中华医学基金会（CMB）资助项目（10 008）

Analysis on the concentration of inpatient services for children with congenital heart disease in Beijing

Abstract:Objective： In this paper, we analyze the concentration of inpatient services for children with congenital heart disease in Beijing Methods： The database of inpatient records was used to collect data on patients aged 0 to 14 years who suffered from four types of congenital heart disease Data was collected on patients hospitalized between 2005 and 2010 From this data，the patient load across different hospitals was determined Logistic regression and multiple linear regression models were used to compare the performance of hospitalization between hospitals with a relatively large number of patients with hospitals with a smaller number of patients Results： More than 93% of pediatric congenital heart disease cases were treated in three main hospitals Hospitals with a relatively high number of cases tended to have better technology, higher quality care, and shorter hospital stay However, the cost trends are not consistent Conclusions and suggestions： Reasonable guidelines should be created to promote general pediatric services in hospitals and to determine the functions and development direction of hospitals according to their individual strengths A format should be created for the scale of pediatric clinical services in hospitals

Key words:Children Congenital heart disease Inpatient services Concentration

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