徐汇区社区家庭病床中医药服务情况调查与分析

Investigation and analysis of traditional Chinese medicine service in community home sickbeds in Xuhui District

目的:了解中医药服务在徐汇区家庭病床中的开展现状与存在问题。方法:于2018年12月对区域内13家社区卫生服务中心家庭病床中医药服务人员的基本情况、家庭病床建床情况及项目开展情况进行调查。同时采用小组访谈法对13家社区卫生服务中心的主任、家庭病床负责人、中医科负责人及部分中医家庭病床医师进行访谈。结果:2018年徐汇区从事家庭病床服务的全科医师共182人,其中中医全科医师87人(47.80%)。2018年徐汇区家庭病床共开展中医非药物适宜技术7699人次,包括针刺、理疗、贴敷、推拿、灸法和药熨等。51人(94.44%)认为开展家庭病床中医药服务有利于基层中医药服务能力的建设;3人(5.56%)认为中医家庭病床的建立对提升基层中医药服务能力的意义不大。按照访谈中受访者所认为的影响因素出现频次,家庭病床中医药服务发展的影响因素依次为绩效分配不合理、工作强度高、工作坏境恶劣、管理部门对家庭病床服务不够重视、缺乏完善的家庭病床中医服务规范和治疗方式受限等。结论:在绩效分配上应考虑到家庭病床开展中医适宜技术的特殊性,同时筛选出更为简便、安全、有效,适合家庭病床患者使用的中医药适宜技术。应对中医家庭病床医师从学历提升、专业技能、沟通能力和管理能力等多方面进行培训,提升其职业认同感及服务水准。

Objective:To understand the status quo and existing problems of traditional Chinese medicine(TCM)service in home sickbeds in Xuhui District.Methods:In December 2018,the basic situation of Chinese medicine service personnel,the construction of home sickbeds and the implementation of the project in home sickbeds of 13 community health service centers in the region were investigated.At the same time,the group interview method was used to interview the directors of 13 community health service centers,heads of home sickbeds,heads of TCM departments and some TCM home sickbeds doctors.Results:In 2018,there were 182 general practitioners who engaged in home sickbed service in Xuhui District,including 87 general practitioners of traditional Chinese medicine(47.80%).In 2018,a total of 7699 cases of non-drug appropriate techniques of traditional Chinese medicine were carried out for home sickbeds in Xuhui District,including acupuncture,physiotherapy,application,massage,moxibustion and medicine ironing.Fifty-one people(94.44%)believed that the development of TCM services in home sickbeds was conducive to the construction of TCM service capacity at the grass-roots level;three people(5.56%)believed that the establishment of home sickbeds of traditional Chinese medicine had little significance in improving the service ability of traditional Chinese medicine at the grass-roots level.According to the frequency of influencing factors considered by the interviewees,the influencing factors of the development of TCM service in home sickbeds in turn were unreasonable performance distribution,high intensity of work,bad working conditions,insufficient attention paid by management to home sickbed service,lack of perfect TCM service standards and limited treatment methods in home sickbeds and so on.Conclusion:The particularity of developing appropriate TCM technology in home sickbeds should be taken into account in performance allocation,and at the same time,the more convenient,safe and effective suitable technology of traditional Chinese medicine for patients in home sickbeds is screened out.It is necessary to train home sickbed physicians of traditional Chinese medicine from the aspects of education,professional skills,communication ability and management ability,so as to enhance their professional identity and service level.