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我国医疗质量和服务显著提升

2017-08-20 08:11:17   中国青年网

据了解,在脑血栓患者中,我国早期抗栓率从80.3%提高到84.6%,吞咽功能筛查率从36.4%提高到83.3%,深静脉血栓预防率从59.6%提高到65.0%。在心血管病方面,行冠脉介入治疗的总病例数2016年达66万多例,较2015年增长17.42%,单个患者平均支架使用数为1.5枚。手术相关死亡率低于千分之三,与发达国家持平。

医疗质量安全稳步提升

郭燕红局长介绍,我国医疗质量的提高伴随着医疗技术的快速发展。一方面,现代科学的新技术、新设备、新理论与新方法相继进入临床实践,并与计算机、分子生物学、遗传工程、高能物理技术等交叉融合;另一方面,随着对疾病认识的进一步深入,专业之间的交叉、渗透、融合日益增多,多专业联合攻关、跨专业融合创新成为解决医学难题的有效途径。

医学的发展显现出“内科外科化,外科微创化”的趋势。近年来,我国以个体化、微创为典型特点的现代医疗技术在临床广泛应用,给群众带来了福祉。

住院死亡率逐步下降,且稳定在较低水平。2015年三级公立综合医院和二级公立综合医院住院患者总死亡率分别为0.71%和0.48%,较2014年分别下降0.03和0.06个百分点;手术患者住院死亡率分别为0.38%和0.21%,其中三级综合医院较2014年下降0.03个百分点,二级综合医院与2014年持平。

医疗服务效率不断提升。2016年医院平均住院日9.4天,比2015下降0.2天;其中三级和二级公立综合医院平均住院日分别为10.1天和8.8天,较2015年分别下降0.3天和0.1天。

抗菌药物使用情况明显好转。医疗机构抗菌药物占比从2010年的19.7%下降到2016年的11.2%;抗菌药物使用率下降幅度约50%;医疗机构细菌耐药上升态势得到遏制。

医疗服务的可及性明显提高。省域内医疗服务同质化水平不断提升。据不完全统计,省域内就诊率达到93%,县域内就诊率平均达到82.7%,较2016年末增长2.3个百分点。50%左右的县医院能够开展颅脑肿瘤手术、颈椎手术等复杂手术,县医院入出院患者诊断符合率、手术前后诊断符合率、病理与临床诊断符合率均超过92%。优质医疗资源上下贯通,基层医疗服务能力稳步提升。2017年上半年,基层医疗卫生机构诊疗量占比平均增长4.7%,由上级医疗机构向下级医疗机构转诊的患者数量同比增长15.1%。

医疗质量管理科学化

保证医疗质量与患者安全是医疗管理的永恒主题。我国是有着13亿多人口的发展中大国,保障人民群众健康的任务十分重大,多年来,国家卫生计生委高度重视医疗质量管理,着力加强制度建设和体系建设,实现医疗服务和质量安全持续改进与提升。

我国多年加强实施临床路径管理。制定印发了覆盖30余个专业、1212个病种的临床路径,在近7000家医院实行了临床路径管理。

同时,逐步完善质量管理组织体系。目前,国家卫计委已成立国家级质控中心36个,基本涵盖了临床主要专业,各省(区、市)成立了相应的质控中心1200余个。各级质控中心协助卫生计生行政部门开展日常质控工作,加强纵向、横向联系,形成工作网络和合力,成为我国医疗质量进步的主要动力之一。

国家卫计委逐步建设和完善国家、省两级医疗质量安全管理信息报告、监测、共享工作机制,提升医疗质量安全管理的精细化水平。近两年,国家卫计委选择具有代表性的质控指标,在行业内发布,以全面客观展现我国现阶段医疗服务和质量安全的形势与现状,并加强区域间比较分析,为促进医疗服务和质量安全持续改进,以及政策制定和加强管理提供循证依据。

通过多措并举,我国已基本形成政府监管、机构自治、行业自律、社会监督的多元共治新格局。

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