摘要
目的基于上海市宝山区社区卫生服务中心夜间门诊诊疗数据,分析急性疾病就诊需求和影响因素,为优化社区夜间门诊资源配置提供实证依据。方法纳入2024年4月1日至2025年7月31日宝山区全部社区卫生服务中心及其下属社区卫生服务站夜间门诊的就诊记录,依据第一诊断将患者分为急性疾病组和非急性疾病组。采用卡方检验和多因素Logistic回归分析比较两组患者的差异。结果共纳入124263例患者,其中急性疾病组21645例(17.4%)、非急性疾病组102618例(82.6%),急性疾病组患者占比排前五位的第一诊断依次为急性上呼吸道感染、急性支气管炎、急性咽炎、结膜炎和急性皮炎。多因素Logistic回归分析显示,女性、低年龄、使用自费卡或异地卡、第一诊断为五官科/眼科/口腔科/皮肤科疾病、在宝山区北部社区就诊及在19:00~20:00时段就诊等是因急性疾病在社区夜间门诊就诊的独立影响因素(P<0.05)。结论宝山区社区夜间门诊急性疾病就诊需求具有明显的人群异质性与时空聚集性,建议通过动态调配医疗资源、优化药品供给保障体系、强化全科医师诊疗能力、推进全科-专科协同服务、延伸家庭医生签约服务等综合措施,实现服务精准供给。
Objective Based on the outpatient data of night clinics in community health service centers in Baoshan District,Shanghai,this study aims to analyze the demand for medical consultations for acute diseases and their influencing factors,providing empirical evidence for optimizing the allocation of community night clinic resources.Methods The medical records of all community health service centers'and their subordinate community health service stations night clinics in Baoshan District from April 1,2024,to July 31,2025,were included.Patients were divided into an acute disease group and a non-acute disease group according to their primary diagnosis.The chi-square test and multivariate Logistic regression analysis were employed to compare the differences between the two groups.Results A total of 124263 patients were included,with 21645 cases(17.4%)in the acute disease group and 102618 cases(82.6%)in the non-acute disease group.The top five primary diagnoses in the acute disease group were acute upper respiratory tract infection,acute bronchitis,acute pharyngitis,conjunctivitis,and acute dermatitis.Multivariate Logistic regression analysis revealed that female gender,younger age,using self-paid or non-local medical cards,primary diagnosis of diseases in the otorhinolaryngology/ophthalmology/stomatology/dermatology departments,receiving medical care in northern Baoshan District community health centers,and seeking medical attention during the 19:00 to 20:00 time slot were independent influencing factors for seeking medical consultations for acute diseases at community night clinics(P<0.05).Conclusion The demand for medical consultations for acute diseases at community night clinics in Baoshan District exhibits significant population heterogeneity and spatiotemporal clustering.It is recommended to achieve precise service provision through comprehensive measures such as dynamically allocating medical resources,optimizing the drug supply system,enhancing the diagnostic and treatment capabilities of general practitioners,promoting collaborative general-specialist services,and extending family doctor contract services.
作者
陈云峰
盖玉婷
顾珊珊
王效国
潘雅萍
秦晟博
CHEN Yunfeng;GAI Yuting;GU Shanshan(Gaojing Town Community Health Service Center,Baoshan District,Shanghai,200435,China;不详)
出处
《中国卫生质量管理》
2026年第2期87-92,共6页
Chinese Health Quality Management
基金
上海市宝山区(2023-2025)医学特色品牌建设计划(编号:BSZK-2023-T07)。
关键词
社区卫生服务中心
急性疾病
夜间门诊
服务需求
Community Health Service Centers
Acute Diseases
Night Clinics
Service Demand
