Study On The Using Of Continuous Medical Service In County Inpatients Based On Medical Alliance

Objective: To investigate the current states and characteristic of the using of continuous medical service in patients hospitalized in the county and township medical institutions with the same disease cycle.Methods: All Inpatient data was exported via the new rural cooperative information management system in the investigation place form 2013 to 2015,respiratory system diseases and cardio-cerebral angiopathy was selected as high hospitalizations diseases in the county and township medical institutions,case tracking method was used to match cases,cases were collected in the investigation place,the matched cases were judged by expert fuzzy evaluation method,evaluation framework was established by medical record evaluation in the county and township medical institutions,included information,management and service dimensions,descriptive statistics was used to describe the current states and characteristic of the using of continuous medical service.Results: 1.The proportion of male and female patients was 50.4% and 49.6% in respiratory system cases.The proportion of male and female patients was 39.3% and 60.7%in cardio-cerebral angiopathy cases.The average age of all study objects was 53.78,the maximum age is 88,and the minimum age is 2.The total population was divided into 0-20,21-40,41-60,and over 61 four age groups.On the whole,the main group was over 60 years old in both respiratory system and cardio-cerebral angiopathy,44.7% and 84.3%respectively,slightly higher than the other age groups.For all study objects,the proportion of unmarried people was 11.5%,the proportion of married population was 85.4%,the proportion of farmers as 92.5%,and the proportion of non-agricultural was7.5%.For admission side,patients were general hospitalized in township and county medical institutions,accounting for 70% and 48.4% respectively.For discharge,the proportion of cured patients in township and county medical institutions was 7.1% and 10.8%respectively,the proportion of improved patients in township and county medical institutions was 59% and 77.8% respectively.The average days of hospitalization in township and county medical institutions were 4.03 days and 6.48 days respectively.Forservice continuity,the proportion of two degree irrational hospitalized patients in Guizhou Province was 10.5% and 6% in township and county medical institutions.The proportion of early,delay and late discharge was 31.9%,4.3% and 5.4% respectively in township medical institutions.The proportion of early,delay discharge was 16.5%、0.3% in county medical institutions.The diagnosis differ between admission and discharge was 6.3% and 22.9% in township and county medical institutions.Unnecessary referral accounts for 19.7% in township medical institutions.For information continuity,the township medical institutions make low contribution to the county medical institutions about medical information,73.2% examination had reference function and 81.5% had no contribution to transfer treatment.The patients had lower awareness on prepared the previous inspection report,and the patients who had invalid information in past and previous information transmission accounted for 45% and 30.8% respectively,caused overexamination may existed in township and county medical institutions.The interval of X-ray examination was 2-7 days accounted for 44.2%.For management continuity,the management coordination was incomplete,the proportion of transfer treatment advice given by the hospital and the doctors was 31.9%,while the proportion of the patients’ own subjective decisions was 62.1%,and the proportion of reverse transfer treatment was only0.9%.Conclusions:County and township inpatients had more or less continuous fracture in the service,information and management three dimensions.For instance,unreasonable admission,inaptitude hospitalization existed in township and county medical institutions.Early or delay discharge,unnecessary transfer treatment existed in township medical institutions.The township medical information made low contribution to the county,and the information system cannot be shared,and the professional advice for transfer treatment from hospitals and doctors was in a low level.