关键词: 可避免住院, 农村卫生, 慢性病, 基本卫生保健, 中西部

Abstract: Background: High-quality primary health care (PHC) can reduce chronic disease complications and prevent severe cases from requiring hospitalization. However, limited attention has been given to PHC quality in rural areas of central and western China. Objective: This study aims to refine the measurement of avoidable hospitalizations using diabetes and hypertension as indicators to assess PHC quality and efficiency in these regions. Methods: Data from 61,450 hospitalizations at three county hospitals (2017-2021) were analyzed. Two categories of avoidable hospitalizations were identified: (1) PHC-preventable but currently unavoidable, and (2) PHC-preventable and currently avoidable. A multilevel logistic regression model assessed influencing factors. Results: Among hospitalizations, 18.1% for diabetes and 49.6% for hypertension were PHC-preventable but unavoidable, while 8.1% and 2.4%, respectively, were PHC-preventable and avoidable. This inefficiency led to an annual waste of approximately 2.37 million yuan. Influencing factors included demographics, health status, insurance, and hospital distance. Conclusion: PHC quality for chronic diseases in rural central and western China is suboptimal, leading to inefficiencies and resource wastage. Improving primary care capacity and PHC quality is essential for better chronic disease management.

Key words: Avoidable hospitalizations, Rural health, Chronic diseases, Primary healthcare, Central and Western China