摘要
目的:分析上海市安宁疗护收费服务项目开展现况与存在问题。方法:于2020年10月采用典型机构调查法在上海市范围内选取开展安宁疗护收费服务的不同类别医疗机构进行问卷调查,共发放调查表37份,回收有效调查表36份,问卷有效回收率97.3%。结果:36家医疗机构中,开展安宁疗护住院服务的有35家,开展居家安宁疗护服务的有26家,全部为社区卫生服务中心。社区卫生服务中心开展的安宁疗护住院服务项目数量最多,其次是康复护理机构,不同类别医疗机构开展安宁疗护住院服务项目的数量差异没有统计学意义(P> 0.05)。社区卫生服务中心共开展居家安宁疗护服务项目449项,不同社区卫生服务中心间开展的中医及民族医诊疗类居家安宁疗护服务项目数量差异较大。中心城区社区卫生服务中心安宁疗护住院服务项目总体开展数量多于近郊和远郊区,其中临床诊疗类和医技诊疗类安宁疗护住院服务项目的数量差异有统计学意义(P <0.05)。近郊区社区卫生服务中心开展综合医疗服务类居家安宁疗护服务项目的数量多于远郊区,差异有统计学意义(P <0.05)。结论:应通过实施安宁疗护相关政策,引导各级各类医疗机构广泛开展同质化安宁疗护服务,探索中医药特色安宁疗护服务模式,建立完善“住院-居家-社区”协同联动的安宁疗护服务提供体系和转介制度。
Objective:To analyze the development status and existing problems of chargeable service items of hospice and palliative care(HPC) in Shanghai.Methods:Typical institutional investigation method was used to conduct a questionnaire survey among various types of medical institutions providing HPC chargeable service items in Shanghai in October,2020.A total of 37 questionnaires were distributed,36 effective questionnaires were collected,and the effective recovery rate was 97.3%.Results:Among 36 medical institutions,35 carried out inpatient HPC service and there were 26 home-based HPC service providers,all of which are the community health service centers.The community health service centers developed the largest number of inpatient HPC service items,followed by rehabilitation and nursing institutions.There was no significant difference in the number of inpatient HPC service items carried out by diverse types of medical institutions(P>0.05).The community health centers carried out 449 home-based HPC service items in total,and the number of home-based HPC service items of traditional Chinese medicine and ethnic medicine diagnosis and treatment carried out by different community health centers varied considerably.The overall number of inpatient HPC service items provided by the community health service centers in central urban areas was more than those in suburban and outer suburban areas,and there was significant difference in the number of inpatient HPC service items of clinical diagnosis and treatment items and medical technology diagnosis and treatment items(P<0.05).The number of home-based HPC service items of comprehensive medical items carried out by the community health service centers in suburban areas was more than those in outer suburb,and the difference was statistically significant(P<0.05).Conclusion:Through the implementation of HPC related policies,all kinds of medical institutions should be encouraged to extensively carry out homogeneous HPC service,explore the characteristic HPC service mode of traditional Chinese medicine,and establish the HPC service delivery system and referral system of “hospitalization-home-community”.
作者
许艺帆
荆丽梅
李雪莹
楚天舒
赵芸稼
陈睿阳
滕晓涵
李水静
XU Yifan;JING Limei;LI Xueying;CHU Tianshu;ZHAO Yunjia;CHEN Ruiyang;TENG Xiaohan;LI Shuijing(Public Health School of Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Primary Health Department of Shanghai Municipal Health Commission,Shanghai 200125,China)
出处
《上海医药》
CAS
2022年第18期15-18,53,共5页
Shanghai Medical & Pharmaceutical Journal
基金
2020年度教育部人文社会科学研究一般项目(20YJAZH045)。
关键词
安宁疗护
收费服务项目
现况调查
hospice and palliative care
chargeable service item
cross-sectional study
