北京农村地区基层医疗服务中就诊者的患病现状分析

目的了解北京农村地区基层医疗门诊就诊者的就诊原因和患病现状。方法在北京的8个郊区和2个县中随机选取2个郊区和1个县，在每个区和县中随机选取1个社区卫生服务中心（乡镇卫生院）及其下属社区卫生服务站或诊所，将所有于2008—04—25到这些中心和站，诊所就诊的全部就诊者作为本次调查的研究对象。结果在社区卫生服务中心就诊的1830例中有71．80％的为40岁以上；就诊原因的前三位分别是：循环系统、呼吸系统、全身性健康问题；在就诊者中慢性非传染性疾病患病率为44．43％，高血压患病率最高，为30．55％，其次是糖尿病为8．09％，其他为冠心病、脑卒中和骨关节病，分别为6．67％，4．75％，3．93％；多数患者（71．96％）仅患一种慢性病，181人（22．26％）同时患有两种及以上慢性病；在1199例接受药物治疗患者中，901例（75．15％）使用西药治疗，580例（48．37％）使用中药治疗，中西药使用率间差异有统计学意义（P〈O．01）；在就诊者中共71例（4．18％）被转诊。结论慢性病已经成为北京农村地区基层医疗服务中的主要健康问题，基层医生与城市中全科医生一样，提高农村地区基层医生对慢性非传染性疾病的诊疗和管理水平是十分必要的。

Analysis on Status of the Patients Encountered in Rural Primary Care in Beijing

Objective To study status of the reason for encounter and morbidity for the patients encountered in primary care in rural area in Beijing. Methods By using cluster sampling method,all the dwellers who encountered the Community Health Service Center of Fang-shan,Yan-qing and Da-xing in Beijing and on April 25th,2008. The Primary care doctor interviewed patients with questionnaires which included basic information,reason for encounter(RFE),diagnosis,treatment / management. Results Most patients in study were over 40(71.80%). There was good agreement between RFE and diagnosis in some organ systems. Circulatory system is the first RFE,the following are respiratory system,General and unspecified health problem. The prevalence rate of chronic non-infectious diseases was 44.43%,hypertension(30.55%) was the most frequent disease,the others were DM(8.09%),CHD(6.67%),stroke(4.75%) and Osteoarthritis(3.93%). Most patients (71.96%) have one kind of chronic non-infectious diseases and 22.26% have two or more chronic diseases. There were 901(75.15%) patients using western medicine and 580(48.37%) patients using Chinese traditional medicine in all of the 1199 patients who were treated by medicine, and there was a significant difference between the rates of western medicine using and the rates of Chinese traditional medicine using. And 71(4.18%) patients were referred. Conclusion The chronic non-infectious diseases is main health problem in rural area in Beijing. It is necessary for the primary care doctors who are working in the rural area in Beijing to promote the clinical skills of screening, diagnosis, treatment and long-term following-up patient with chronic non-infectious diseases.