上海市乡村医生上门服务现状调查与分析

Survey and Analysis on Visiting a Patient at Home of Rural Doctors in Shanghai

目的从对乡村医生上门服务内容和方式调查入手,分析上门服务存在的问题,为完善上海市乡村医生服务提供科学参考。方法采用分层整群随机抽样的原则,调查并分析上海市8个郊区(县)24个乡镇72个村160名乡村医生每天上门服务的详细工作情况。结果和讨论上海市每天每村卫生室上门服务1.3次,从0点到24点均有出诊,服务内容主要是为病人提供疾病治疗、慢性病诊治以及脆弱人群保健。灵活的出诊和上门服务方式保留良好;8小时工作时间以内提供的医疗服务占39.8%,8小时以外医疗服务占64.4%,村医上门服务时间范围远大于8小时。村卫生室至上门服务点路上耗费时间平均为23.4min,使用代步工具主要以自行车,电瓶车或摩托车为主,与世界卫生组织"在家中或步行15分钟的距离之内有适当的卫生设备"的要求还有一定差距,有待进一步改进。

OBJECTIVE The aim of this paper was to survey the contents and means of visiting a patient at home of rural doctors in Shanghai,and analysis possible problems,to supply the scientific gist for improving the services of rural doctors in Shanghai.METHOD This paper was guided by the principles of stratified cluster random sample.And the detail work of visiting a patient at home of 160 rural doctors was investigated,who were in 72 villages of 24 towns from 8 counties in Shanghai.RESULTS and CONCLUSIONS There were 1.3 times of visiting a patient at home every day in Shanghai, and there was a visit from 0：00 to 24：00, and the content of the service was mainly for the patients with chronic diseases as well as the health of vulnerable groups. So the flexible service of visiting a patient at home was kept all right. The times of visiting a patient at home in 8-hour working hours were accounted for 39.8%, and the times out of 8-hour working hours were accounted for 64.4 percent. It indicated the working time of rural doctors visiting a patient at home was much larger than 8-hour time frame. The time of visiting a patient at home spending on the road was an average of 23.4 minutes, and the main means of transport were bikes, battery-bikes and motorcycles. There was a certain gap with the requirement of WHO＂ at home, or a 15-minute walk distance there are adequate sanitation＂ , so it must be improved.