摘要
目的了解上海市基层社区家庭病床上门服务项目提供现状,为完善管理提供依据。方法根据上海市家庭病床数据汇总表,统计2017年上海市基层社区开展上门服务项目情况。结果上海市中心城区和郊区可开展上门服务项目数均值分别为27.61±7.44、21.37±10.40,已开展上门服务项目均值分别为21.23±8.12、17.57±10.93,比较差异P值均<0.01。全市有超过82.92%的基层社区可开展6项家庭病床上门服务检查项目,超过80%的基层社区可开展换药、护理指导、导尿、康复指导、预约出诊、肌肉注射等家庭病床上门服务治疗项目。结论上海市中心城区与郊区可开展和已开展家庭病床上门服务项目数存在较大差异,可提供家庭病床服务项目与患者需求之间也存在较大差距。可借鉴国外经验,从政府、机构、患者三方入手,多方发力,共同促进家庭病床工作持续开展。
Objective To investigate the present situation of family health care on-site service items in Shanghai community health service institutions,and to provide evidence for management. Methods According to the summary table of Shanghai family health care data,the on-site service items by Shanghai community health service center in 2017 were analyzed. Results The mean numbers of available on-site service items in urban and suburban areas of Shanghai were 27.61±7.44 and 21.37±10.40,respectively,and the mean numbers of available on-site service items were 21.23±8.12 and 17.57±10.93,respectively,with all P<0.01.More than 82.92%community health service centers can carry out six family health care on-site service items,and more than 80%of community health service centers can carry out family health care on-site service items of dressing change,nursing guidance,catheterization,rehabilitation guidance,appointment of home visits,intramuscular injection,etc. Conclusion Significant difference existed in the number of family health care on-site service that can be carried out and have been carried out between the urban and suburban areas of Shanghai,and there were also gap between the family health care on-site service items provided and the needs of patients.The mature experience of foreign countries can be learned and efforts should be made in various ways from three aspects of the government,institutions and patients to jointly promote the continuous development of family health care.
引文
[1]钟彩英,吴翠平,黄树琴,等.深圳市社区失能老人现状及其家庭病床服务需求调查[J].黑龙江医学,2016,40(5):457-459.
[2]曹海涛,黄冬娟,徐学凡,等.上海中心城区家庭病床3年工作量调查与分析[J].中华全科医学,2015,13(6):986-988.
[3]苏萍,王亚坤.上海市花木社区2013-2015年家庭病床服务分析[J].医学理论与实践,2017,30(1):136-138.
[4]张秀红,冯伟,奚勇强,等.上海市郊区某社区卫生服务中心开展家庭病床服务的实践与思考[J].中国初级卫生保健,2016,30(9):22-24.
[5]凡芸,乐霞,彭幼清,等.家庭病床患者一般健康状况调查分析[J].中国全科医学,2012,15(7):2311.
[6]顾和平,陈耀玉.上海市家庭病床卫生服务项目调查与思索[J].中国初级卫生保健,2012,26(2):25-27.
[7]孙斌,董恩宏,杨海燕,等.上海家庭病床患者对社区护理的需求调查与分析[J].中国医院管理,2017,37(5):75-77.
[8]上海市质量技术监督局.上海市家庭病床服务规范[Z].2010.
[9]孙肖潇,孙国新,梁茵,等.医护人员上门医疗服务开展现状及执业风险分析[J].上海预防医学,2016,28(4):250-253.
[10]刘天洋,郝晓宁,薄涛,等.美国家庭病床护理服务体系及其启示[J].卫生经济研究,2016(11):10-12.