Abstract: Background　With the change of functional orientation，community health centers（CHCs） become a supplier for general healthcare services consisting of 6 types（prevention，medical，healthcare，health education，rehabilitation services and guidance on family planning） instead of mainly medical services，and the original specialty wards such as internal，surgical and gynecology and obstetrics have become the general wards. Understanding the composition of diseases in inpatients receiving general care in CHCs helps primary care institutions to accurately identify the patients' health needs and formulate targeted disease prevention and treatment strategies. Objective　To investigate the composition of diseases in inpatients receiving general care from suburban community health centers，Pudong New Area，providing a reference for the implementation of targeted interventions for disease prevention and treatment，and for carrying out appropriate professional trainings for medical workers. Methods　Retrospective analysis was used to analyze the sex ratio，age，first diagnosis and other data of discharged patients from the general wards of suburban CHCs，Pudong New Area from 2015 to 2017. These information were derived from "Shanghai Medical Institutions Medical Records Statistical Management System". Results　From 2015 to 2017，there were a total of 49 352 patients discharged from the general ward in the suburb CHCs of Pudong New Area，including 27 294 females（55.30%），and 22 058 males（44.70%）. 42.59% （21 019/49 352） of them aged 80 and above. The top 3 systemic diseases were respiratory diseases〔40.95%（20 208/49 352）〕，circulatory system diseases〔32.46%（16 021/49 352）〕，and digestive system diseases〔7.32%（3 611/4 352）〕. The monthly percentage of these 3 systemic diseases showed that among the total discharged patients，respiratory disease patients accounted for the largest percentage in January〔13.94%（2 816/20 208）〕，circulatory system disease patients accounted for the largest percentage in March〔9.53%（1 527/16 021）〕，and digestive system disease patients accounted for the largest percentage in August〔12.21 %（441/3 611）〕. The top 3 single illnesses were sequelae of cerebral infarction〔12.90%（6 244/49 352）〕，chronic obstructive pulmonary disease with acute lower respiratory tract infection〔12.65%（6 366/49 352）〕，and acute bronchitis〔9.44%（4 658/49 352）〕. The top one single illness was chronic obstructive pulmonary disease with acute lower respiratory tract infection 〔17.75%（3 915/22 058）〕 in males，and was sequelae of cerebral infarction〔13.37%（3 649/27 294）〕 in females. Conclusion　Among the discharged patients from general ward of suburban CHCs，Pudong New Area，elderly patients with chronic diseases accounted for the largest percentage；the peak incidence was associated with season；the challenges to prevent and treat cerebral infarction and chronic obstructive pulmonary disease were great. In view of this，general practitioners in these CHCs，the main supplier for healthcare services，should formulate disease prevention and treatment strategies in accordance with the patient's age，disease profile，peak incidence，and other features as well as the conditions of the CHCs，and improve the delivery of demand-oriented community health services. Besides，comprehensive abilities of community general practitioners and nurses should be improved by strengthening the theoretical and practice trainings regarding the diagnosis and treatment of high-incidence diseases in the community.

Key words: Community health services, Inpatient, Disease composition, Single disease

摘要： 背景　随着社区卫生服务中心的功能定位由原来的医疗为主转变为“六位一体”综合健康服务，社区原有的内科、外科、妇产科等专科病房也转变成了综合病房。了解社区综合病房住院患者的疾病构成情况，对于基层医疗卫生机构准确把握服务对象健康需求、制订疾病防治策略有重要意义。
目的　了解浦东新区远郊社区综合病房住院患者的疾病构成情况，为实施针对性的疾病防治措施、开展医护人员专业培训提供参考依据。方法　采用回顾性分析，对浦东新区所有远郊社区卫生服务中心综合病房2015—2017年出院患者的性别、年龄、第一诊断等资料进行分析，这些信息均从“上海市医疗机构病案统计管理系统”导出。结果　2015—2017年，浦东新区远郊社区综合病房出院患者共49 352人次，女27 294人次（55.30%），男22 058人次（44.70%）；≥80岁者占42.59%（21 019/49 352）；系统疾病排前3位的依次为呼吸系统疾病（40.95%，20 208/49 352）、循环系统疾病（32.46%，16 021/49 352）、消化系统疾病（7.32%，3 611/49 352）；前3位系统疾病的月分布显示，呼吸系统疾病1月份出院人次占比最高（13.94%，2 816/20 208）、循环系统疾病3月份占比最高（9.53%，1 527/16 021）、消化系统疾病8月份占比最高（12.21%，441/3 611）；单病种排前3位的依次为脑梗死后遗症（12.90%，6 366/49 352）、慢性阻塞性肺疾病（COPD）伴急性下呼吸道感染（12.65%，6 244/49 352）、急性支气管炎（9.44%，4 658/49 352）；男性单病种首位是COPD伴急性下呼吸道感染（17.75%，3 915/22 058），女性单病种首位是脑梗死后遗症（13.37%，3 649/27 294）。结论　远郊社区卫生服务中心综合病房以老年慢性病患者为主，发病高峰与季节有关；脑梗死、COPD的防控压力较大。远郊社区卫生服务中心的全科医生作为诊疗服务的主体，应根据患者年龄、疾病谱、发病高峰等特点，结合社区实际制订疾病防治策略，完善以需求为导向的社区健康服务；同时，针对社区高发病种，加强相关理论知识及操作技能培训，提高全科医生及社区护理人员的健康服务综合能力。

关键词: 社区卫生服务, 住院患者, 疾病构成, 单病种