关键词: 社区卫生中心, 住院病人, 诊断, 疾病构成, 影响因素分析, 城乡结合部, 上海

Abstract: Background　Most of the community health centers（CHCs） in Shanghai have retained the system of hospital wards，which alleviates the problem of poor access to inpatient services to a considerable extent.However，how to deal with the patients having a long duration of hospitalization，and to improve the imbalance between insufficient inpatient services and residents' needs of inpatient services，have become the challenges faced by CHCs.Objective　To survey the number and disease profile of patients discharged from CHCs in Shanghai's rural-urban fringe.Methods　Data of 25 CHCs in Shanghai's Jiading District and Minhang District were collected in January 2017，including the number of doctors，number of serving people，and use of beds in 2016 obtained via a survey with these CHCs using a self-developed "Community Health Center Information Questionnaire"，and the diagnosis and hospitalization information of patients discharged in 2016 obtained via the health information management system.In the end，the data of 22 institutions was eligible and included.Results　In 2016，the 22 CHCs had 11 839 discharges in total.The bed rotation rate and occupancy rate were 3.86 and 85.96%，respectively.The average age of the discharged patients was（82.3±4.6） years old.The numbers of GPs and beds were associated with the number of discharges（P<0.05）.66.31%（7 851/11 839） of the discharged patients had at least 2 diagnoses.The top 3 principal diagnoses among these patients were cerebral infarction（n=1 117，9.43%），hypertension（n=698，5.90%） and coronary heart disease（n=661，5.58%）.Conclusion　In these CHCs，the majority of inpatients are old people，mostly have cardiovascular or cerebrovascular diseases，with a high prevalence of multimorbidity.The number of beds and GPs may influence the discharges.

Key words: Community health centers, Inpatients, Diagnosis, Disease constitution, Root cause analysis, Rural-urban fringe, Shanghai