北京市医疗机构低视力康复服务状况调查

Survey on rehabilitation services for low vision of medical institutions in Beijing

目的 了解北京市医疗机构低视力康复服务能力及现状，为政府低视力康复工作提供政策依据。设计 横断面研究。研究对象 北京市二级及以上医院90家。方法 通过问卷形式对90家医疗机构低视力康复工作进行调查，调查问卷由各调查机构视光和眼科负责人填写。收集的资料进行统计分析。主要指标 问卷应答率、是否开展低视力服务、不能开展低视力服务的原因、低视力康复年服务量、种类、人员状况及助视器的种类。结果 90家医疗机构中，做出有效应答的医疗机构86家，应答率95.56%。可提供低视力康复服务的医疗机构6家（6.98%）。医疗机构未开展低视力康复服务的原因依次是缺乏基本设备和助视器、缺乏资金、缺乏低视力专业人员以及没有患者来源。各家医疗机构提供的年服务量少者为0~49例，多者大于250例，年总服务量不足600人。低视力工作人员仅有19位。6家医院可提供光学近用助视器，3家医院可提供光学远用助视器，2家医院可提供电子助视器，6家医院均不能提供非视觉助视器，均未开展儿童功能性视力康复训练、日常生活能力和技能康复训练、职业训练、适应及行走训练等康复服务。购买助视器的资金来源有患者自费或非政府机构的资金支持，各种助视器的支付均未纳入医保范围。结论 北京市医疗机构低视力康复服务能力远远不能满足低视力患者的需求，应加强北京市低视力康复服务能力。

Objective To understand the ability and situation of low vision rehabilitation services in medical institutions of Beijing and to provide evidence for future planning and policy making for low vision rehabilitation in Beijing. Design Cross-sectional study. Participants 90 medical institutions in the second-tier and third-tier municipal hospitals of Beijing. Method A questionnaire survey was conducted to investigate the low vision rehabilitation servicesin the 90 hospitals of Beijing. Persons who were charge of optometry and ophthalmology department filled the questionnaire. The data were collected and statistical analysis was performed. Main Outcome Measures Response rate, provide low vision rehabilitation services or not, main reason of no low vision rehabilitation services, the annual workload andtype of low vision rehabilitation services, staff of low vision rehabilitation service, and types of low vision devices. Results In 90 medical institutions, the effective response rate was 95.56%（86/90）. There were 6 medical institutions（6.98%） which could provide low vision rehabilitation services. Main reasons of no low vision rehabilitation services includedshortage of basic equipmentand low vision devices, shortage of fund, shortage of low vision professionals and limited source of patients. The annual workload in the six medical institutions was as low as 0-49 cases, and high as more than 250 cases. The total annual workload in all institutions was less than 600 cases. There were only 19 staff members working for low vision rehabilitation. Optical near devices were provided in 6 hospitals, and optical distance devices were provided in 3 hospitals, while digital devices were provided in 2 hospitals. All the 6 hospitals did not provide functional visual rehabilitation training for children, daily life and technical training, vocational training, adaption and mobility orientation. The cost of low vision devices was not covered by medical insurance, and mainly paid by patients themselves or fund from non-governmental organizations. Conclusion The capacity of low vision rehabilitation services in municipal medical institutions of Beijing was far from enough to meet the needs of low vision patients. The capacity of low vision rehabilitation services in Beijing need be improved.