门诊服务利用论文：门诊服务利用疾病监测合理用药次均处方费用

1、门诊服务利用论文：门诊服务利用疾病监测合理用药次均处方费用【中文摘要】通过对样本地区村卫生室20042009年门诊登记和处方费用的现场调查，研究农村居民门诊服务利用情况，评价农村居民门诊服务利用趋势及处方费用变化情况，为新型农村合作医疗制度提供政策建议。方法收集样本地区哨点村卫生室20042009年门诊登记和处方登记，采用现场机构资料调查法，提取病人就诊信息和处方费用,并运用描述性统计分析、趋势卡方检验和Logistic回归等方法进行统计分析。结果(1)2534岁生育高峰的女性与男性就诊构成比的差异达到最高值；(2)65岁的女性就诊构成比均小于男性;(3)老年人群在各阶段就诊比例均最高；(4)

2、呼吸系统疾病、消化系统疾病、循环系统疾病、损伤和中毒、皮肤和皮下组织疾病、肌肉骨骼系统和结缔组织疾病分别位于农村居民门诊服务利用就诊原因(疾病)的前六位；(5)幼童中呼吸系统疾病比例很高；随着年龄增长，循环系统疾病构成比例有上升趋势；青少年中，皮肤和皮下组织系统疾病占有较高比例；中年人中，损伤和中毒占有较高比例；女性在育龄期生殖系统疾病所占比例上升；(6)村卫生室抗生素、支持类、全身用激素在门诊人次的使用比例较高，分别为41.1%28.8%9.30%,中药饮片使用很少，中成药使用较多；(7)新农合制度实施后，抗生素、抗病毒类药物和全身用激素的使用下降，支持类药物使用上升；(8)门诊药物联用现象

3、明显,抗生素联用严重；(9)样本地区村卫生室次均处方费用随阶段增加总体女性高于男性。结论研究认为，应重视女童、育龄妇女和老年人群等特殊群体的健康情况，关注常见病、多发病和慢性病防治策略，加强抗生素、支持类和全身用激素等门诊用药管理。促进合理安全用药,控制处方费用不合理上涨。【英文摘要】Throughinvestigatingtheinformationoftheinvestigatedareasmedicalservicesinruralclinicsandruralmedicalpractitionersatthescene,tomonitorthesituationonthehealthc

4、areserviceprovideandutilization,toevaluatethetrendsofruralresidentsout-patientservicesutilizationandthecostofprescriptionsatvillageclinics,toexploretheinflueneeofoutpatientserviceandprovidespolicysuggestionsforthenewruralcooperativemedicalsystem.MaterialsandmethodsThesurveyincludethe20042009outpatie

5、ntprescriptionsandregistersof4villageclinicsininvestigatedfourtownshipareas.Investigatedagencyinformationatthescenetocollectandextractvillagehealthclinicpatientsinout-patientregistrationinformationandtreatmentandcostofprescriptions.Usingthedescriptivestatistics,achi-squaretestandlogisticregressionto

6、analysisthedata.Results(1)Womenwhobetween2534yearoldaremorethanmenbecauseofbabyboom.(2)Femaleintheagegroup65yearsarelessthanmen.(3)Doctorhasthehighestpercentageoftheageingpopulation.(4)Respiratorydiseases,digestivesystemdiseases,circulatorydiseases,injuryandpoisoning,skinandsubcutaneoustissuedisease

7、sanddiseaseofthemusculoskeletalsysteminthevillageislocatedthetopsixinout-patientdiagnosisofruralresidentsdiseaseconstitute.(5)Youngchildrenforahighproportionofrespiratorysystemdisease.Increasingwithage,circulationsystemdiseaseconstitutesaproportionisontherise.Inteenagers,theskinandsubcutaneoustissue

8、systemdiseasepossesshighproportion.Inthemiddle-agedgroup,injuryandpoisoningpossessthehigherpercentageproportion.Womenwhointhebabyboomstage,thereproductivesystemdiseasespossessthehigherpercentageproportion.(6)Theantibiotics,thesupportandhormonesinthebodywiththeuseofvillageoutpatientvisitshadahigherproportion,respectively41.1%,28.8%and9.3%.ThenumberofChinesetraditionalmedicineprescriptionsdeclined,therewasanincreaseintheapplicationofTraditionalChinesepatentmedicines.(7)aftertheNCMS,theuseoftheantibiotics,theanti-virusandthecortinforwholebodydecreaseandthesupportincrease.(8)Theproportionofout