上海市城、郊两社区卫生中心住院患者住院状况调查

目的 了解社区卫生服务中心患者的基本情况及床位使用情况.方法 收集上海市中心城区徐汇区康健街道社区卫生服务中心（简称康健社区）、远郊的金山工业区社区卫生服务中心（简称工业区社区）城、郊两家中心住院患者的人口学及病房资料,同时采用自制的调查问卷,对两家社区卫生中心某日住院患者的病种、平均住院天数、日常生活能力评分（ADL评分）、住院目的、出院后的去向等情况进行现况调查.结果 康健社区住院患者共138例,工业区社区住院患者共77例,两中心住院患者≥60岁老人的比例分别为100.0％（138/138）、98.7％（76/77）.康健社区住院患者前3位单病种均为心脑血管疾病,累计构成比86.9％（120/138）;工业区社区住院患者前3位单病种分别为高血压、脑梗死、急慢性支气管炎（或肿瘤）,累计构成比65.0％（50/77）.康健社区、工业区社区两中心住院患者平均住院天数分别为609.6、253.8 d（F=2 604.000,P=0.000）,极严重功能障碍和严重功能障碍患者合计占比分别为84.0％（116/138）、32.5％（35/77）（x^2=80.911,P=0.000）,不愿出院者比例分别为87.7％ （121/138）、57.1％ （44/77）,两社区比较差异有统计学意义（P＜0.05）.结论 目前社区卫生服务中心病房以老年患者为主要服务对象,住院病种相对集中.城、郊社区住院患者的住院目的、住院时间、日常生活能力评分等方面存在差异.

Survey on hospital beds utilization of rural and urban community health service centers in Shanghai

Objective To survey on utilization of hospital beds in rural and urban community health centers in Shanghai. Methods The hospital beds utilization was investigated in one rural and one urban community health service centers in Shanghai. The data of hospitalized patients in a selected day were surveyed with self-made questionnaire, including the demographic information of patients, the diseases category, the length of hospital stay, self-care ability of daily life （ADL score ）, the purpose of hospitalization, and the management after discharge. Results Patients aged over 60 y accounted for 100. 0% （138/138） in urban center and 98.7% （76/77） in rural center. The three top disease categories were all cardio or cerebrovascular diseases in urban center accounting for 86. 9% （120/138）, while those in rural center were hypertension, cerebral infarction and acute/chronic bronchitis （or tumor ） accounting for 65.0% （50/77）. The mean length of hospital stay in urban and rural centers were 609.6 d and 253.8 d, respectively （F = 2 604. 00, P = 0. 000）. Patients with severe dysfunction in urban and rural centers accounted for the 84. 0% （ 116/138 ） and 32.5% （ 35/77 ）, respectively （ X^2 = 80. 911, P =0.000） . Patients not willing to be discharged in urban and rural centers accounted for 87.7% （121/138） and 57. 1% （44/77）, respectively in city and rural centers （ P 〈 0. 05 ）. Conclusions The wards in community health centers mainly serve the elderly patients. There are differences in purpose of hospitalization, length of hospital stay, ADL scores of patients between rural and urban community health centers.