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目的以上海交通大学医学院附属仁济医院南院与上海市闵行区政府合作建立的门急诊医保患者联合信息为基础,探索上海市郊新建三级医院建成开业对周边区域医疗资源配置的影响。方法采用定性研究与定量研究相结合的研究方法。半结构式访谈用于确定仁济南院和闵行区政府健康档案中数据关联字段、内容以及架构;差异性检验用于检验周边医疗需求的变化差异,验证医疗资源配置的有效性。结果定性研究结果确认包括“居住地(区、镇、村或居委)”和“仁济南院门急诊就医时间”等10个字段;通过信息整合将仁济南院所有门急诊医保患者(73.9万人次,占就医患者总体数量的66.8%)信息与闵行区政府健康档案关联,患者最集中来源为医院所在地浦江镇(2013年和2014年分别占59.0%和52.8%);就诊学科分布方面,除风湿病科外,其余学科的分布与均值接近。结论仁济南院作上海市郊新建的4家三级医院之一,其保障当地居民医疗效果显著,特色医疗的辐射能力逐步显现,充分体现了资源设置的初衷,但区域医疗资源联合尚待加强。
Objective To explore the impact of the completion of the construction of a newly constructed tertiary hospital in the outskirts of Shanghai on the allocation of medical resources in the peripheral areas based on the joint information of outpatient and emergency medical services patients established by the South Hospital of Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine and the government of Minhang District of Shanghai. Methods using qualitative research and quantitative research methods of combining research. Semi-structured interviews are used to determine the field, content, and structure of the data associated with the government health records of Renjiadin Hospital and Minhang District. Discrepancy tests are used to test for differences in the demand for peripheral medical services and to verify the effectiveness of the allocation of medical resources. Results The results of qualitative research confirmed that 10 fields including “living place (district, town, village or neighborhood committee) ” and “hospital emergency attendance in Jinan ” and so on. Through information integration, The information of patients (739,000 people, accounting for 66.8% of the total number of medical patients) was related to the Minhang District government health record. The most concentrated source of information was Pujiang Town, where the hospital was located (59.0% and 52.8% in 2013 and 2014 respectively) Distribution, in addition to rheumatology, the distribution of the remaining subjects and the average close to. Conclusion Renjiin Hospital is one of the four tertiary hospitals newly established in the suburbs of Shanghai. It ensures that the medical effects of local residents are remarkable, and the radiological capabilities of special medical services are gradually emerging. This fully embodies the original intention of setting up resources, but the joint regional medical resources have yet to be strengthened.