上海市创伤急救病人院内诊治模式调查

发布时间：2018-04-08 20:58

本文选题：创伤　切入点：院内诊治模式　出处：《中国卫生资源》2016年02期

【摘要】：目的 :了解上海市医疗机构创伤急救病人院内诊治模式现状,推动创伤急救体系与国际接轨。方法 :通过实地走访调查、焦点讨论、专家论证等多种方法,了解14所医疗机构中创伤院内急救的行政建制、院内创伤急救医师队伍的设置和培训水平等情况,比较创伤急救病人院内诊治模式对多发伤救治死亡率的影响。结果 :目前上海各医疗机构的急救病人院内创伤诊治模式主要有两种,第一种模式为创伤中心制,有5所;第二种模式为急诊科首诊负责制和/或急救中心全科医师制,有9所。第一种模式在创伤专用急救设施、急诊检查与手术室配置相对比较完善,且在创伤患者分级评分、创伤专业团队规范化业务培训优于第二种模式;两种模式创伤急救医师的学历构成、职称结构、专业结构配置和专科背景无显著差异;两种模式在建立院内创伤数据库方面都不够完善,难以为创伤急救质量的评价提供客观标准。结论 :目前上海市多数医院仍然采取急诊科首诊负责制或急救中心全科医师制,创伤中心制的医疗机构在创伤患者的急救方面具有管理模式上的优势,建议有条件的医院尽早成立创伤中心,加强创伤急救人才队伍的规范培训、从全市层面建立创伤数据库迫在眉睫。
[Abstract]:Objective: to understand the medical institutions of Shanghai city emergency trauma patients present hospital diagnosis and treatment mode, promote the trauma care system with international standards. Methods: through field investigation, the focus of the discussion, experts and other methods, the administrative system about 14 medical institutions in the trauma emergency care in hospital, hospital trauma emergency physician team setting and training level, influence of trauma emergency patient hospital diagnosis and treatment mode of treatment of multiple trauma mortality. Results: at present, the Shanghai medical institutions of emergency patients in hospital trauma diagnosis and treatment mode mainly has two kinds, the first kind of pattern for trauma center system, there are 5; second kinds of patterns for the first diagnosis responsibility system and emergency department the emergency center and / or general practitioner system, 9. The first model in special trauma emergency facilities, emergency inspection and operation room configuration is relatively perfect, and the score in the classification of trauma patients, major trauma The team is better than the standardized second modes of training business; two kinds of mode of trauma emergency physician qualifications, job title structure, there was no significant difference between specialty structure and specialized background; two modes in the establishment of hospital trauma database is not perfect, it is difficult to provide an objective standard for evaluating the quality of emergency trauma. Conclusion: at present, Shanghai city most hospitals still take the first diagnosis responsibility or emergency center emergency department physician for medical institutions, trauma center system has the advantage of management mode in the emergency trauma patients, the proposed conditional hospital as soon as possible to set up the trauma center, strengthen the standardized training of trauma emergency personnel, from the city level to develop trauma database is imminent.

【作者单位】：上海市医学会学术继教部;复旦大学附属中山医院骨科;上海市浦东新区周浦医院骨科;同济大学附属同济医院骨科;上海长征医院神经外科;上海市第六人民医院骨科;上海市第一人民医院创伤中心;复旦大学附属华山医院骨科;上海市奉贤区中心医院骨科;上海市青浦区中心医院急诊科;
【基金】：上海市卫生和计划生育委员会科研课题(201440586)
【分类号】：R641

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