上海市社区卫生服务中心中医专题社区诊断项目现状调查分析

Community Health Diagnosis Project on TCM Theme:A Status Survey in Community Health Service Centers in Shanghai

目的了解上海市社区卫生服务中心中医专题社区诊断项目开展情况。方法以2012年上海市示范社区卫生服务中心现场检查评估材料以及2012年上海市中医药特色示范社区卫生服务中心中期评估检查资料为资料来源,对上海市51家社区卫生服务中心2009—2011年的51份中医专题社区诊断报告从形式、书写格式、主要诊断方法和内容完整性4方面进行分析。结果 52.9%(27/51)的中医专题社区诊断报告以独立成篇的形式完成;书写格式以简化版为主,占66.7%(34/51);采用的主要诊断方法是问卷调查法(76.5%),而定性、定量综合应用方法仅占21.6%(11/51),选题小组法所占比例更少(2.0%);内容完整率<60%的所占比例最高,为56.9%(29/51),内容完整率>80%的仅占5.9%(3/51)。在18项内容中,涉及比例最高的4项内容是:中医体质辨识(82.4%)、社区卫生服务中心中医药服务需要与利用指标(76.5%)、社区环境特征(74.5%)和人口学指标(74.5%);涉及比例最低的3项内容是:社区中医药总资源指标、≥60岁老年人健康状况与生活质量指标(5.9%)和孕产妇健康状况(19.6%)。结论中医专题社区诊断项目是开展社区中医药服务首要的基础性工作,但目前上海各社区卫生服务中心的中医专题社区诊断报告与卫生部规范要求尚存在较大差距,建议制定中医专题社区诊断技术手册,提高中医专题社区诊断质量。

Objective To explore the developing situation of community health diagnosis project on traditional Chinese medicine（TCM） theme in Shanghai community health service centers（CHSC）.Methods Based on the on-site assessment data of Shanghai demonstration CHSC（2012） and the mid-term evaluation data of Shanghai TCM demonstration CHSC（2012）,51 community diagnosis reports on TCM theme from 2009 to 2011 were analyzed in 4 aspects：forms,formats,the main diagnostic methods,content integrity in 51 CHSCs in Shanghai.Results The 52.9%（27/51） of the reports were completed in form of a separate chapter.The main format was simplified,accounting for 66.7%（34/51）.The main diagnostic method was questionnaire（76.5%）,while qualitative,quantitative methods accounted only for 21.67%（11/51）,nominal group process for less（2.0%）.The reports with more than 60% of content integrity accounted for 56.9%（29/51）,those with less than 80% for only 5.9%（3/51）.In the 18 items,the 4 highest-proportion contents were TCM constitution identification（82.4%）,indexes of CHSC demands for TCM and its utilization（76.5%）,indexes of community environment characteristics（74.5%） and demography（74.5%）;the 3 lowest-proportion contents were total indexes for TCM community resources,indexes for over-60-year-old people′s health status（5.9%）,health status of pregnant and lying-in women（19.6%）.Conclusion Community health diagnosis project on TCM theme is premier groundwork for development of community TCM services,but there is still a wide gap between community diagnostic reports of Shanghai CHSCs and the code requirements of Ministry of Health.TCM Thematic Community Diagnosis Manual is suggested being formulated to improve the quality of community health diagnosis on TCM theme.