湖北省社区卫生服务中心中医药标准化建设现状

Current Situation of Standardized Construction of TCM in Community Health Center in Hubei Province

目的了解湖北省城市社区卫生服务中心(CHCs)自身中医药资源配备和中医药服务开展达标情况,为CHCs中医药服务建设提供参考。方法采用国家中医药管理局统一制定的问卷,对湖北省CHCs的中医药人力资源、中医科及中药房配置、中药配备及中医药服务在"六位一体"功能中的运用情况进行普查,参照2003年国家中医药管理局颁布的《CHCs中医药服务基本管理规范》要求,计算湖北省CHCs中医药资源配备与服务的相关指标达标率。结果湖北省CHCs共234家,大、中、小城市分别为95家(40.6%)、73家(31.2%)、66家(28.2%)。(1)湖北省大、中、小城市CHCs中医医师占医师总数15%以上的达标率分别为17.9%、16.4%、37.9%(P=0.003),50%的临床医师接受省级以上中医全科培训的达标率分别为2.1%、4.1%、1.5%(P=0.158);(2)单独设立中医科的达标率分别为70.5%、32.9%、51.5%(P<0.001);(3)单独设立中药房的达标率分别为94.7%、79.5%、81.8%(P=0.008);(4)中药饮片(家)品种数大于250种的达标率分别为75.8%、52.1%、47.0%(P<0.001),中成药品种数大于50种的达标率分别为88.4%、56.2%、65.2%(P<0.001);(5)中医预防传染病的达标率分别为77.9%、68.5%、62.1%(P=0.088),中西医结合防治2种以上慢性病的达标率分别为86.3%、74.0%、63.6%(P=0.004),建立中医健康档案的达标率分别为83.2%、65.8%、66.7%;运用4种以上中医疗法种数的达标率分别为97.9%、83.6%、75.8%(P<0.001);(6)中医保健达标率分别为84.2%、72.6%、60.6%(P=0.003),中医康复达标率分别为94.7%、87.7%、69.7%(P<0.001),中医健康教育达标率分别为90.5%、82.2%、71.2%(P=0.007),中医计划生育技术服务达标率分别为74.7%、49.3%、54.5%(P=0.002);(7)湖北省大、中、小城市CHCs中医药人力资源达标率分别为2.1%、0.0%、0.0%;中医药机构配置达标率分别为66.3%、24.7%、39.4%;中药配备达标率分别为66.3%、42.5%、37.9%;中医药在"六位一体"中同时应用的达标率分别为55.8%、23.3%、25.8%(P<0.001);中医药人员、机构、药品及服务均达标的综合达标率分别为2.1%、0.0%、0.0%(P<0.001)。结论湖北省小城市CHCs人力资源配备高于大、中城市,大城市CHCs其他资源高于中、小城市,大城市CHCs中医药服务达标率最高,小城市最低。

Objective To know the target hitting situation of TCM(traditional Chinese medicine)service and TCM resource allocation of community health centers (CHCs) in Hubei province ,and to provide references to TCM service construction in CHCs. Methods With the questionnaire made by State Administration of TCM of China(SATCM),the application situation of human resource ,department and office allocation ,Chinese herbs ,and TCM service in“Six in One”function in CHCs in Hubei were surveyed ,referred to“Primary Management Standard of TCM Services in CHCs”issued by SATCM in 2003,to calculate the rate of reaching standard of the TCM resource allocation and TCM service in CHCs in Hubei. Results There were 234 CHCs in Hubei,95(40. 6%)in big cities,73(31. 2%)in middle cities ,66(28. 2%) in small cities. (1) In CHCs in big ,middle ,small cities in Hubei ,the reaching standard rates that TCM doctors in total sum of doctors higher than 15%were 17. 9%,16. 4%,37. 9%( P =0. 003),respectively. The reaching standard rates that the clinicist received TCM training higher than 50% were 2. 1%,4. 1%,1. 5%( P = 0. 158). (2) The reaching standard rates that the TCM department was independently set were 70. 5%,32. 9%,51. 5%( P < 0. 001). (3) The reaching standard rates that the TCM pharmacy was independently set were 94. 7%,79. 5%,81. 8%( P=0. 008). (4)The reaching standard rates that prepared slices of Chinese crude drugs higher than 250 kinds were 75. 8%,52. 1%,47. 0%( P <0. 001),and the rates that Chinese patent drugs higher than 50 kinds were 88. 4%,56. 2%,65. 2%( P<0. 001).(5)The reaching standard rates that utilized TCM to prevent communicable disease were 77. 9%,68. 5%,62. 1%( P= 0. 088),the rates that used combination of TCM and western medicine to treat more than 2 kinds of chronic disease were 86. 3%,74. 0%,63. 6%( P=0. 004),the rates that the TCM health records were set reached 83. 2%,65. 8%,66. 7%,the rates that utilized the TCM therapies more than 4 kinds were 97. 9%,83. 6%,75. 8%( P<0. 001).(6)The reaching standard rates of TCM health care were 84. 2%,72. 6%,60. 6%( P =0. 003),the rates of TCM rehabilitation were 94. 7%,87. 7%,69. 7%( P<0. 001),the rates of TCM health education were 90. 5%,82. 2%,71. 2%(P=0. 007),the rates of TCM technique service of family planning were 74. 4%, 49. 3%,54. 5%( P = 0. 002). (7) In CHCs in big ,middle ,small cities in Hubei ,the reaching standard rates of TCM human resources were 2. 1%,0. 0%,0. 0%;the rates of TCM agency configuration were 66. 3%,24. 7%,39. 4%;the rates of Chinese medicine allocation were 66. 3%,42. 5%,37. 9%;the rates of application of TCM in“Six in One”were 55. 8%,23. 3%,25. 8%( P < 0. 001);the comprehensive reaching standard rates were 2. 1%,0. 0%,0. 0%( P < 0. 001). Conclusion The human resources allocations in CHCs in small cities in Hubei are higher than those in big and middle cities ,other CHCs resources in big cities are higher than those in middle and small cities ,the reaching standard rates of TCM in CHCs in big cities are the highest and in small cities are the lowest.