重庆市一、二级医疗机构延续护理服务现状及影响因素分析

Current status of continuity nursing services in primary and secondary medical institutions in Chongqing,China and related influencing factors

目的:调查和分析重庆市一、二级医疗机构延续护理服务的现状,并探讨其影响因素。方法:以便利抽样法选取重庆市一、二级医疗机构为调查对象,对延续护理服务开展形式、项目及障碍因素进行调查和分析。结果:共计70家(37.8%)二级医院,115家(62.2%)一级医院参与调查。所有参与机构均已开展延续护理服务,其中科室随访和出院前准备是最常见的形式,管道护理和外科护理是最常见的上门护理服务内容。二元logistic回归分析发现,政策支持力度不够(OR=3.912)、患者对收费项目接受度低(OR=2.733)是开展延续护理服务所面临的障碍因素。结论:重庆市一、二级医疗机构延续护理服务仍处于初级阶段,服务形式单一、服务内容呈现碎片化,服务模式还需进一步丰富;政府、医疗机构需双方合力,完善卫生管理政策和医疗保障制度,打破不同机构信息壁垒,提升服务主体能力,实现延续护理服务关系、信息、管理连续性,促进延续护理需求-供给平衡,构建一个多方共赢互利的良性延续护理服务生态圈。

Objective:To investigate the current status of continuity nursing services in primary and secondary medical institutions in Chongqing,China and related influencing factors.Methods:The convenience sampling method was used to select primary and second-ary medical institutions in Chongqing as respondents,and investigation and analysis were performed for the forms,projects,and barri-ers of continuity nursing services.Results:A total of 70(37.8%)secondary hospitals and 115(62.2%)primary hospitals participated in the survey.All participating institutions had implemented continuity nursing services,with departmental follow-up visits and pre-discharge preparations as the most common forms,and pipeline care and surgical care were the most common contents of home-based nursing services.The binary logistic regression analysis showed that insufficient policy support(OR=3.912)and low acceptance of fee-charging items by patients(OR=2.733)were barriers to implementing continuity nursing services.Conclusion:Continuity nursing ser-vices in primary and secondary medical institutions in Chongqing are still at an early stage with limited service forms and fragmented service contents.Therefore,it is needed to further enrich service patterns,and government agencies and healthcare institutions need to work together to improve health management policies and healthcare insurance systems,break down information barriers between differ-ent institutions,and enhance the capacity of institutions,so as to realize the continuity of relationship,information,and management in continuity nursing services,promote the balance between demand and supply in continuity nursing,and create a mutually beneficial ecosystem for continuity nursing services.