探討基本醫(yī)療與住院服務(wù)供應(yīng)和利用的關(guān)系

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【中圖分類號】R197【文獻(xiàn)標(biāo)識碼】A DOI：10.12114/j.issn.1007-9572.2025.0065

【Abstract】Inpatientcareandambulatorycareconstitute the nationalandregional healthcare system.Therelationship betweenthetwosubsystemsisasignificanttopicthatneeds tobestudied.UsingpubliclyreleaseddataofChinaandinteational agencies，thispaper preliminarilyanalyses the statusand trendsofhospital inpatient service provisionandutilizationand potential influencingfactors，aswellastherelationshipbetweenprimarycareandinpatientcare.Theresultsshowthathospital admisionratesinChinaarepositivelycorrelatedwiththedegreeofpopulationagingandtheavailabilityofhospitalbeds，with synchronousgrowthobservedinbedavailability，utilzationrates，andgeneralpractitionerresoures.Hospitaladmiionates varysignificantlyacrossprovinces.Thehospitalizationratecannotbesatisfactorilyexplainedwithcommonlyusedindicatorssuch associoeconomic，populationstructure，and healthresourceallocation，butgeographicdensityof hospitalbedsisrelatedto socioeconomicandpopulationindicatorsandotherresouestructures.Internationally，thesupplyofhospitalbedsisdecreasing inhigh-incomecountries，increasing inmidle-incomecountries，andremainingatalowlevelinlow-incomecountries；the hospitalizationateisrelated topopulationaging，economicdevelopment，andhospitalgovernancepolicies.Ithasbeenwidely realizedthatexcesive provisionof expensive inpatientcare willmakethehealthsystemunsustainable.Thehealthcareystem reformsare focusingonearlydiseaseprevention，consolidatingand strengthening primaryhealthcareandbasic medical care， andchangingthetraditionalroleofhospitals.High-incomecountrieshavereducedthesupplyandutilizationofhospitalization services through various measures，midle-incomecountriesareexploring thegovernanceofhospitalizationservices，andlowincomecountriesareexploringhowtoincreasesupplyandutilizationof inpatientcare.Strengthening basicmedical services does not necessarilyleadtoarductionininpatintservices，buttoimprovethecosteffectivenessandfirnesofregionalmedical servicesandoptimize theuseof inpatientresources.Efective govermanceof inpatient careand primarycare，establishmentand developmentoflarge-scale andcompetentbasic medical services，implementationofsharedcare acrossthe subsystems andaply gatekeper systems，and measures to reduce avoidable hospitalizations for specific diseasesand specific populations can help primary care contribute more rational inpatient care.

【Key Words 】Primary care；General practice；Hospital beds；Inpatient care；Supply；Utilisation

我國醫(yī)療衛(wèi)生系統(tǒng)的改革和發(fā)展進(jìn)入“深水區(qū)”，其中一個重要的考量和博弈，是怎樣在醫(yī)院住院服務(wù)（inpatientcare）的提供和利用上，與非住院服務(wù)（ambulatorycare，包括基層社區(qū)的全科服務(wù)和各類門診?？品?wù)）平衡，促進(jìn)和實現(xiàn)區(qū)域醫(yī)療衛(wèi)生服務(wù)資源更好的配置效率和價值，從而在實現(xiàn)可持續(xù)發(fā)展的同時，維護(hù)和提高我國居民的健康水平和生活質(zhì)量。（剩余16487字）