农村地区重性精神疾病管理治疗一体化人力资源配置标准及分档服务内容研究

发布时间：2018-01-10 04:00

本文关键词：农村地区重性精神疾病管理治疗一体化人力资源配置标准及分档服务内容研究　出处：《中国全科医学》2014年23期 　论文类型：期刊论文

【摘要】：目的分析样本地区精神卫生人力资源现状,剖析其配置中存在的问题,探索在农村地区开展医院社区一体化重性精神疾病患者管理治疗所需的人员资质、来源、配置标准及分档服务内容。方法 2009年7月,采用现场调查、深入访谈、文献复习法总结国内外重性精神疾病管理治疗的人力资源现况,形成重性精神疾病管理治疗标准技术流程和人力资源配置标准设计方案,之后在河北地区的省、市、县、乡、村级进行人员配置并进行培训,对105例不稳定重性精神疾病患者采用标准技术流程进行为期6个月的医院社区一体化管理治疗。因缺乏市和县级精神卫生机构,省级同时担负了市和县级职责。采用工作分析法记录各岗位人员的服务项目及工作时间,计算全职当量人数(EFT,以工作8 h/d为EFT 1人),并分别计算医院和社区提供不同服务和频率时所需的EFT。结果 (1)社区精神病管理涉及的岗位有精神科医生和护士、心理治疗师、社工、职业治疗师,在农村可由受过培训的执业/助理医师、社康护士、村医及村干部等协助工作。(2)医院社区提供分档服务,根据提供服务的内容和频率不同,精神卫生服务分为基础、中、高3个配置标准。(3)参与管理治疗的工作人员共117人,折合EFT=17.02人,管理重性精神疾病患者的精神卫生人力资源配置应为EFT 14.18人/10万人口。根据提供服务的内容和频率不同,得出基础配置、中档配置、高档配置标准分别为每10万人口EFT为9.17(医院∶社区=3.80∶5.37)、14.18(医院∶社区=4.50∶9.68)、20.51(医院∶社区=4.80∶15.71)人。结论医院社区一体化的管理治疗模式能为患者提供更全面的服务,培训基层卫生人员和村干部在一定程度上可满足基础精神卫生服务。
[Abstract]:Objective to analyze the present situation of mental health human resources in the sample area, analyze the problems existing in its allocation, and explore the personnel qualifications and sources for the management and treatment of hospital community integrated mental disease patients in rural areas. Methods in July 2009, field investigation, in-depth interview and literature review were used to summarize the current situation of human resources in the management and treatment of major mental disorders at home and abroad. Form the standard technical process of management and treatment of mental illness and the standard design scheme of human resources allocation, and then conduct staffing and training in Hebei province, city, county, township and village level. 105 patients with unstable mental illness were treated with standard technical procedure for 6 months. The provincial level is responsible for both the city and the county level. The service items and working hours of each post are recorded by work analysis method, and the equivalent number of full-time workers is calculated. The EFT is one person working 8 h / d). The EFTs needed by hospitals and communities to provide different services and frequencies were calculated. Results 1) Psychiatrists and nurses, psychotherapists, social workers, occupational therapists were involved in community psychiatric management. In rural areas, the service may be provided by trained practising / assistant doctors, community nurses, village doctors and village cadres, etc.) the hospital community can provide divisional services, depending on the content and frequency of the services provided. Mental health services were divided into basic, medium, high 3 configuration criteria. 3) the total number of staff involved in the management of treatment was 117, equivalent to EFT=17.02. The mental health human resource allocation of the patients with severe mental illness should be 14.18 people / 100,000 population of EFT. According to the content and frequency of service, the basic allocation and mid-range allocation were obtained. The EFT per 100,000 population was 9.17 (hospital: 3.80: 5.37) 14.18 (hospital: community 4.50: 9.68). 20.51 (hospital: 4.80: 15.71). Conclusion the integrated management and treatment model of hospital community can provide more comprehensive services for patients. Basic health personnel and village cadres can be trained to a certain extent to meet the basic mental health services.
【作者单位】：河北省精神卫生中心;北京大学精神卫生研究所卫生部精神卫生学重点实验室;上海交通大学附属精神卫生中心;
【基金】：2011年河北省医学科学研究重点课题计划(20110022)——重性精神疾病管理医院-社区一体化模式的研究与实践
【分类号】：R197.1
【正文快照】： 从2004年开始,精神卫生被纳入公共卫生领域,成为中国政府改善农村和城市初级卫生保健的优先领域[1]。河北省清苑县作为首批中央补助地方经费重性精神疾病管理治疗项目(686项目)的60个示范区之一,通过6年的工作实践,农村精神卫生服务工作取得了较好效果,医院社区一体化服务模式

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