Holcík J, Koupilová I, Gerylovová A
Ustav sociálního lékarstvi a verejného zdravotnictví LF MU, Brno.
Cas Lek Cesk. 1997 Nov 5;136(21):662-5.
The objective of the present study was to use available data provided by the programme Health Services Indicators (HSI) for partial analyses focused on the estimated health services needs in different districts of the Czech Republic (CR) and on evaluation of some intentions of the health policy.
After evaluation of the standardized and gross mortality rates in different districts of the CR the authors evaluated relationships of selected indicators recorded in 1995. The correlation of the gross mortality as an orientational estimate of health services needs in different districts of the CR and expenditures of health insurance companies for health care per one insured subject was low and was not statistically significant (r = -0.062). A close correlation with expenditure of health insurance companies was found with the number of doctors (r = 0.894), the number of nurses (r = 0.842) and the number of hospital beds (r = 0.679). The number of population per general practitioner correlated only weakly with the expenditure of health insurance companies (r = 0.012). A marked correlation (r = -0.676) was found between the percentage of general practitioners from the total number of doctors in the district and expenditures of the health insurance companies.
The authors recommend that the role of general practitioners in the system of health care should be appreciated and that primary care should be conceived as the basis of effective, economical and high standard health care. It is desirable that HSI data should become the baseline of systematic operational research into health services.
本研究的目的是利用健康服务指标(HSI)计划提供的现有数据,进行部分分析,重点关注捷克共和国(CR)不同地区的估计健康服务需求以及对一些卫生政策意图的评估。
在评估了CR不同地区的标准化死亡率和总死亡率后,作者评估了1995年记录的选定指标之间的关系。CR不同地区的总死亡率作为健康服务需求的定向估计与每家保险公司为每位参保对象的医疗保健支出之间的相关性较低,且无统计学意义(r = -0.062)。发现医生数量(r = 0.894)、护士数量(r = 0.842)和医院病床数量(r = 0.679)与保险公司的支出密切相关。每位全科医生的人口数量与保险公司的支出仅呈微弱相关(r = 0.012)。发现地区医生总数中全科医生的百分比与保险公司的支出之间存在显著相关性(r = -0.676)。
作者建议应重视全科医生在医疗保健系统中的作用,并且应将初级保健视为有效、经济和高标准医疗保健的基础。HSI数据应成为健康服务系统运营研究的基线,这是很有必要的。