《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (10): 933-937.

• 康复管理 • 上一篇    下一篇

我国大陆省会城市综合医院康复服务现状调查分析

李建军1,2;刘松怀1,2;高峰1,2;宓忠祥1,2;吴春容1,2;杨明亮1,2;杜良杰1,2;曹丽敏1,2;陈夏尧1,2;杨世兵3   

  1. 1.首都医科大学康复医学院,北京市 100068;2.中国康复研究中心,北京市 100068;3. 首都医科大学卫生管理与教育学院,北京市 100069
  • 收稿日期:2009-08-15 出版日期:2009-10-01 发布日期:2009-10-01

Investigation and Analysis on Status of Rehabilitation Services in Comprehensive Hospitals of Capital Cities in China Mainland

LI Jian-jun,LIU Song-huai,GAO Feng,et al   

  1. Capital Medical University School of Rehabilitation Medicine, Beijing Charity Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2009-08-15 Published:2009-10-01 Online:2009-10-01

摘要: 目的 调查了解我国大陆综合医院康复科的建立和康复服务的现状。方法 采用问卷调查法,分层对全国大陆31个省、自治区、直辖市的省会城市240家不同等级综合医院医学康复科的设置、康复业务的开展、康复专业人员配备、康复工作面临的问题等方面进行调查,并就东部经济发达地区和中西部经济欠发达地区、不同等级综合医院进行分组统计分析。结果 回收有效调查问卷表216份(三级、二级和一级医院各72份),并且东部与中西部地区组间无显著差异(P=0.61)。在医学康复科设置方面,有69%综合医院设立医学康复科,并且地区医院间康复科设置无差异(P=0.30),不同级别医院康复科设置有差异(P=0.000);在康复业务开展方面,有97.2%医院开展康复服务,有60%的医院能满足康复患者的需求,并且医院等级间及东部与中西部地区医院间无显著性差异(P>0.05);在康复专业人员配备方面,76.4%医院有康复医师,64.8%有运动治疗师(PT),52.3%有中医师,50.5%有作业治疗师,36.6%有语言治疗师,17.6%有心理康复治疗师,只有2.3%社会康复工作者,物理治疗师、作业治疗师、言语治疗师东部医院明显好于中西部医院(P<0.01),康复医师、物理治疗师、作业治疗师、言语治疗师、心理治疗师三级医院明显好于二级和一级医院(P<0.01);综合医院康复服务面临的前5位问题为:康复专业人员数量不足(63.9%)、康复训练的场地不够(51%)、缺乏现代化的康复业务管理软件系统(50.5%)、康复设备陈旧(49.6%)、康复治疗项目收费标准偏低(49.1%)。结论 综合医院在医学康复科的建设、专业人员的设置、服务的质量和范围、康复资源的有效利用、康复管理和行业准入、相关政策的配套、康复人才培养还存在许多问题,国家要加大综合医院康复工作的投资及配套政策的实施,特别要加大中西部省份综合医院及二级、一级医院康复工作的扶持力度,才能更有效地发挥综合医院在残疾人康复事业中作用。

关键词: 康复, 机构, 服务, 资源, 管理, 对策

Abstract: Objective To investigate the status of the establishment and service of the rehabilitation departments in comprehensive hospitals in China mainland.Methods A questionnaire survey was conducted in 240 comprehensive hospitals with different grades distributed in the capital city of 31 provinces, autonomous regions, and municipality cities in China mainland in a stratified sampling way. The contents investigated are the settings of rehabilitation departments, the performances of the rehabilitation services, the staffing of the rehabilitation workers and the problems faced in rehabilitation. Then, statistical analysis were done between the developed eastern regions and economically less developed middle-western regions, as well as different grades of comprehensive hospitals. Results In total, 216 valid questionnaires were collected (72 tertiary hospitals, 72 secondary hospitals and 72 primary hospitals), and there are no statistically difference between eastern regions and middle-western regions(P=0.61). About 69% of the hospitals surveyed have built up the rehabilitation departments, and there are no statistically difference between different regions (P=0.30). As far as the performance of the rehabilitation services are concerned, 97.2% of them have carried out rehabilitation service, 60% of them can satisfy the demands of the patients, and there are no difference between the different grades and between the eastern and middle-western regions(P>0.05). In addition, 76.4% of them have rehabilitation doctors, 68.4% have physiotherapists(PT), 52.3% have traditional Chinese medicine doctors, 50.5% have occupational therapists(OT), 36.9% have speech therapists(ST), 17.8% have psychologists, and only 2.3% have social workers. The staff status on PT, OT and ST of the hospitals in eastern regions are significantly better than that in middle-western regions(P<0.01), and the staff status on rehabilitation doctors, PT, OT, ST and psychologists in the tertiary hospitals are significantly better than that in the secondary hospitals and primary hospitals(P<0.01). Finally, the first five problems the rehabilitation department faced are following: short of professional workers(63.9%), lack of training areas(51%), lack of modern rehabilitation service management system (50.5%), out-of-date equipments(49.5%) and low fees of rehabilitation treatment(49.1%). Conclusion Many problems exists in the rehabilitation departments of comprehensive hospitals, such as the development of rehabilitation departments, the professional workers, the quality and width of the service, the efficient use of rehabilitation resources, rehabilitation management and profession permission, the relative policies and regulations, personnel training and so on. Therefore, the government should enhance to put the supported policies into practice, and reinforce investment to the comprehensive hospitals, in particular, enhance the support of the comprehensive hospitals in middle-western regions, as well as the primary hospitals and the secondary hospitals, all of which will play a much more efficient role in rehabilitation for the disabled in the comprehensive hospitals.

Key words: rehabilitation, institution, service, resource, management, strategy