广州地区中医院康复服务能力提升研究

发布时间：2018-09-12 15:24

【摘要】：目的:在充分挖掘康复医疗服务建设相关文献资料的基础上,了解康复医疗服务的发展历程、国内外研究现状以及国家和广东省为推进康复医疗服务能力建设所采取的政策措施,从而对国内外在康复事业领域的研究能够有全面的理解;通过开展调查研究广州地区中医院康复科建设情况,掌握广州地区中医院康复医疗服务开展基础以及供给能力;使用数据包络分析法对广州地区中医院康复医疗服务效率进行分析,找出效率存在的问题,提出有效提高康复医疗服务质量和效率的建议。方法:1、采用文献归纳法,系统归纳国内外康复医疗服务开展的现状和存在问题,分析和总结广州地区康复医疗服务开展概况,从而更全面地认知康复医疗服务,并为调查问卷、访谈提纲和测算指标的选取奠定基础;2、采用问卷调查法,调查广州地区22所二级及以上中医医院康复医疗服务开展情况;3、运用卫生统计学方法,对调查问卷数据进行描述性统计分析和统计学检验;4、采用访谈法,依托广东省中医药局平台,利用座谈会和个人访谈的形式,结合文献研究资料,针对研究内容设计访谈提纲,对涉及康复医疗管理和服务的相关专家进行访谈,访谈对象涵盖医院管理学专家、医院管理层领导、康复科负责人以及康复专业人员,了解各位专家对提升康复医疗服务能力的意见和想法;5、运用数据包络分析法对广州地区中医院康复医疗服务效率进行分析,分析效率存在的问题,提出有效提高康复医疗服务质量和效率的建议。结果:广州地区中医院康复医疗服务能力存在以下问题:(1)康复科建设与管理制度不完善;(2)康复专业人才匮乏,尤其体现在康复治疗师数量少,质量低,康复科专业人员职称结构、学历结构等不合理;(3)康复设备配置不全面;(4)康复转诊开展力度不足,大部分上下级医院未签订转诊协议,未能落实分级诊疗制度;(5)康复医疗项目医保报销比例低;(6)康复医疗服务效率有待提高,尤其是三级中医医院康复科规模偏大;(7)康复支出和康复设备投入冗余,康复科总诊疗人次和康复收入产出有待提高。结论:针对发现的存在问题建议从以下方面进行改善:(1)完善中医医院康复科建设与管理规范;(2)加大对康复专业人才的培养力度;(3)合理配置与利用康复医疗服务资源,提升康复医疗服务能力;(4)畅通双向转诊渠道,逐步完善三级康复医疗服务体系;(5)完善康复医疗保障制度,争取配套政策的支持;(6)控制康复科过快扩张,合理配置康复医疗资源,避免资源浪费,提高产出。
[Abstract]:OBJECTIVE: To understand the development history of rehabilitation medical service, the research status at home and abroad, and the policies and measures taken by the state and Guangdong Province to promote the rehabilitation medical service capacity building on the basis of fully tapping the relevant literature of rehabilitation medical service construction, so as to have a comprehensive understanding of the research in the field of rehabilitation at home and abroad. Through investigating and researching the construction of rehabilitation department in Guangzhou Traditional Chinese Medicine Hospital, grasping the basis and supply ability of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital; using data envelopment analysis method to analyze the efficiency of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital, finding out the existing problems of efficiency, and putting forward effective measures to improve the quality of rehabilitation medical service. Methods: 1. Adopting the method of literature induction, this paper systematically summarizes the current situation and existing problems of rehabilitation medical services at home and abroad, analyzes and summarizes the general situation of rehabilitation medical services in Guangzhou, so as to more comprehensively understand rehabilitation medical services, and lays a foundation for the selection of questionnaire, interview outline and measurement index; 2. Adopting the method of literature induction. Using questionnaire survey method, this paper investigates the development of rehabilitation medical services in 22 secondary and above hospitals of traditional Chinese medicine in Guangzhou area; 3. Using health statistics method, descriptive statistical analysis and statistical test of the questionnaire data; 4. Using interview method, relying on the platform of Guangdong Provincial Bureau of Traditional Chinese Medicine, using the form of Symposium and personal interview, combined with the text. Presents the research material, designs the interview outline according to the research content, carries on the interview to the related expert which involves the rehabilitation medical treatment management and the service, the interview object covers the hospital management expert, the hospital management leadership, the rehabilitation department responsible person as well as the rehabilitation specialized personnel, understands each expert to enhance the rehabilitation medical service ability the opinion and the idea; Data envelopment analysis (DEA) was used to analyze the efficiency of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital, and the existing problems were analyzed. Suggestions for improving the quality and efficiency of rehabilitation medical service were put forward. Professional personnel shortage, especially in the number of rehabilitation therapists, low quality, rehabilitation professionals Title structure, academic structure unreasonable; (3) rehabilitation equipment configuration is not comprehensive; (4) rehabilitation referral to carry out inadequate, most of the lower and upper hospitals have not signed referral agreements, failed to implement the classification of medical treatment system; (5) rehabilitation medical insurance projects Reimbursement rate is low; (6) Rehabilitation medical service efficiency needs to be improved, especially the scale of the rehabilitation department in the tertiary hospitals of traditional Chinese medicine is relatively large; (7) Rehabilitation expenditure and equipment input redundancy, the total number of patients in the rehabilitation department and the output of rehabilitation income need to be improved. Standardization of rehabilitation construction and management; (2) Enhancing the training of rehabilitation professionals; (3) Rationally allocating and utilizing the resources of rehabilitation medical services to enhance the ability of rehabilitation medical services; (4) Unobstructing the two-way referral channels, gradually improving the three-level rehabilitation medical service system; (5) Perfecting the rehabilitation medical security system, striving for the support of supporting policies; (6) Controlling the health The Department of rehabilitation should expand rapidly, rationally deploy rehabilitation medical resources, avoid waste of resources and increase output.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.4

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