我国医疗机构儿科床位配置现状研究

目的：分析我国医疗机构儿科床位配置现状及公平性,为合理配置儿科床位提供建议。方法：在全国随机抽取44个地市,对提供儿科住院服务的医疗机构儿科床位设置、服务提供和利用情况进行问卷调查。结果：我国平均每千人口拥有儿科床位0.20张。县区级医疗机构床位数量最多,占44.9%,乡级机构次之,占29.4%,市级及以上机构最低,占25.7%。2008—2010年儿科床位数和服务数量均呈现增长趋势,其中中部地区床位数增长最快。儿科床位利用率高于全国医疗机构整体床位利用率。全国儿科床位配置泰尔指数为0.0775,各地区之间为0.0164。不同地区的儿科床位供需比值在0.54～1.04之间。结论：我国儿科床位总体数量不足,儿科床位比例基本合理,东中西部地区内部儿科床位分布不公平性大于地区间不公平性。建议：各级政府在区域卫生规划中加强对儿科床位的合理配置,适当增加县区级及以上医疗机构的儿科床位数,调整综合性医院内部床位设置,增加儿科床位比例。同时加强省市级儿童医院的建设,并加强各级医疗机构之间的分工和合作,完善基层机构和上级机构之间的双向转诊机制。

Research on allocation of pediatric beds in medical institutions in China

Objective： To analyze allocation and equity of pediatric beds in medical institutions. Methods： 44 cities were randomly selected throughout the country and surveyed using a questionnaire of service quality and utilization of pediatric beds as well as the supply and demand of medical institution hospitalization services for children. Results： The average number of pediatric beds is 0. 2 per thousand people in China. The constituent ratio of beds in medical institutions at county level is higher than the municipal and township level, which are respectively 44. 9%, 25.7% , 29.4%. Both the number of beds and service in pediatrics revealed an increasing trend from 2008 to 2010 and the Central China has the fastest growth in beds. The availability of bed in pediatrics is higher than whole bed utilization of national medical institution. The Theil index of allocation of national pediatric beds and different regions is respectively 0. 077, 0. 0164. The supply-requirement ratio of pediatric beds is 0. 54 - 1.04 in different regions.Conclusions ： The number of pediatric beds is insufficient. The proportion of pediatric beds is reasonable as a whole. The inequity of distribution of pediatric beds within areas is higher. In terms of the regional health layout, it is suggested that governments at all levels should strengthen the appropriate allocation of pediatric beds and properly increase its number in medical institutions at county levels and adjust the internal allocation of beds to increase the proportion of pediatric beds in general hospitals. Meanwhile, governments should strengthen the construction of children＇s hospitals at provincial or municipal level and cooperation among different medical institutions to perfect the two-way referral system between primary and higher institutions.