| Objective: To investigate the disease spectrum of inpatients in Chenzhou area,city level and county level for four years,and compare the medical service ability of the specialty with seven types of system diseases with the larger disease spectrum at county level and to find out the short board and put forward the suggestions for the specialty capacity construction.Methods: Data of the first page of medical records of 25 public hospitals in Chenzhou from 2015 to 2018 and the data of nine county public general hospitals and specialties were collected and Excel database was established and analyzed statistically by spss22.0.The comprehensive evaluation index system and specialty evaluation index system of county hospital were established through literature review and national policies.This paper analyzes the characteristics of disease spectrum at all levels in Chenzhou area,and evaluates the medical service ability of seven specialties of nine county hospitals corresponding to systemic diseases which account for a large proportion of disease spectrum at county level.Results:1.There was no statistical difference found in disease spectrum of 20 types of system diseases in Chenzhou area in each year(P >0.05);Compared with the disease spectrum at city and county level,only the factors influencing health status and contacting with health care institutions were statistically different(P < 0.05);The top seven diseases in the disease spectrum of five public general hospitals in central urban area were circulatory system diseases,factors affecting health status and contacting with health care institutions,pregnancy,childbirth and puerperium diseases(P < 0.05);Only musculoskeletal system and connective tissue diseases were significantly different among the top seven diseases in the disease spectrum of public general hospitals in nine counties(P < 0.05).2.The number of inpatients with the top seven CIS diseases in Chenzhou area accounted for 70% of the total number of 20 diseases.The disease spectrum of inpatients in other areas is basically the same as that of systemic diseases,but the order of systemic diseases in different areas is different.3.The number of inpatients with the top seven CIS diseases in the city level accounted for 68% of the total number of 20 diseases.Compared with the top seven systemic diseases in the disease spectrum of city and county level,the city level has more factors affecting health status and health care institutions contact,and tumor system diseases than the county level.4.The number of inpatients with the seven ranking diseases in the county level accounted for 78% of the total number of 20 diseases.Compared with the top seven systemic diseases in the city and county-level disease spectrum,there are more injuries,poisoning and some other consequences of external causes,musculoskeletal system and connective tissue diseases in the countylevel than in the city-level.5.The major specialties of the disease in the top seven ranking of county-level disease spectrum were respiratory medicine,cardiovascular medicine,gynecology and obstetrics,general surgery,orthopedics,digestive medicine and urology.6.The comprehensive ability of each county hospital was classified from high to low,which were F hospital,I hospital,K hospital,H hospital,L Hospital,m hospital,n hospital,G hospital and j hospital.Among the nine county hospitals,F hospital has the best development in orthopedics and general surgery,K hospital has the best development in urology and cardiovascular medicine,I hospital has the best development in obstetrics and gynecology and digestive medicine,and l hospital has the best development in respiratory medicine.7.The evaluation score of the ability of county hospitals with respiratory system diseases,circulatory system diseases,musculoskeletal system and connective tissue diseases and urogenital diseases were not correlated with the number of inpatients in the special year,the number of inpatients in the special year and the average number of residents per million people per year of county system diseases(P > 0.05).There was a positive correlation between the scores of specialty ability evaluation and the number of inpatients in specialty years(P < 0.05).There was no correlation between the number of inpatients in specialty years and the average number of inpatients per 10000 people in county system diseases(P> 0.05).8.The most common diseases in respiratory medicine were influenza and pneumonia.The most common diseases in obstetrics and gynecology were childbirth.Urology accounts for a large number of diseases,all of which are urolithiasis.The major diseases in cardiovascular medicine are hypertension in hospital F and the other 8 specialties are ischemic heart disease.The major diseases in orthopedics are injuries of trunk,limbs or body unspecified parts in hospital F,and the other 8 specialties are other back diseases.The major diseases in digestive medicine are non-infective colitis and colitis in hospital L,and the other 8 specialties are esophageal,gastric and duodenal diseases.The general surgery in F hospital,G hospital,I hospital,K hospital,L Hospital,m hospital and N hospital accounts for other diseases of intestine.The general surgery in H hospital and J hospital accounts for the larger diseases of gallbladder,biliary tract and pancreas.9.The score of the specialty ability of nine county hospitals is different and the development is unbalanced.Nine departments of respiratory medicine,cardiovascular medicine and gastroenterology can meet the standard of medical service ability at county level;Nine orthopedics and urology departments can basically meet the standard of medical service ability at county level;Only f hospital can basically meet the requirements,and the other eight hospitals can only meet the requirements of some county-level medical service capacity.Conclusion:1.The annual disease spectrum of inpatients in Chenzhou area is stable,the inpatients are increasing year by year,and the structure of systemic diseases has no obvious change.2.The first seven ranking diseases in the city level disease X spectrum in Chenzhou area are more than those of county level,which have more factors affecting health status and health care institutions contact,and tumor system diseases,which are two kinds of systemic diseases,namely,the tumor patients in the municipal hospitals and the patients with medical care and medical beauty needs are more than those in county hospitals.3.The first seven CIS diseases in Chenzhou county level are more serious than those of the city level,which include injury,poisoning and external causes,musculoskeletal system and connective tissue diseases.That is to say,the trauma patients in county-level hospitals are more than those in municipal hospitals,and county-level hospitals should enhance the ability of pre-hospital care and first aid.4.The demand for medical services for the top seven ranking diseases in Chenzhou county-level disease spectrum is mainly respiratory medicine,cardiovascular medicine,gynecology and obstetrics,general surgery,orthopedics,digestive medicine and urology.That is,county hospitals should vigorously improve the medical service ability of these seven specialties.5.The evaluation score of the three types of diseases is positively correlated with the number of inpatients in the specialty year,that is,the more the specialized ability of the nine hospitals is,the stronger the specialized ability of the patients in obstetrics,general surgery and digestive medicine.6.The difference of the specialty ability of each hospital and hospital at county level is quite large,the establishment of the specialty is incomplete and the development is unbalanced.Respiratory medicine,cardiovascular medicine,obstetrics and gynecology,general surgery,orthopedics,gastroenterology and urology can basically meet the requirements of the county-level medical service ability standard,and surgery also needs to strengthen the specialty ability construction.There are more inpatients in the top seven diseases in the county hospitals,so we can focus on learning and developing related technology to improve the ability of medical service. |
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