| 上海市全科医生对专科疾病的诊疗现状研究 |
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| 引用本文： | 杨蓉,方宁远,金花,潘莹,王朝昕,石建军,范会芹,于德华.上海市全科医生对专科疾病的诊疗现状研究[J].中华全科医学,2020,18(8):1251-1255. |
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| 作者姓名： | 杨蓉 方宁远 金花 潘莹 王朝昕 石建军 范会芹 于德华 |
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| 作者单位： | 1. 同济大学附属杨浦医院全科医学科, 上海 200090; |
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| 基金项目： | 2018年上海市卫生计生委课题(201840132)2018年上海市“医苑新星”青年医学人才培养资助计划2018年上海市医师协会医院管理研究基金(201802037) |
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| 摘 要： | 目的 本次研究旨通过问卷调查的方式了解上海市社区卫生服务中心全科医生对专科疾病的诊疗现状,为社区全科医师的继续教育提供方向,以提高社区全科临床质量,进一步促进全科医学发展。 方法 在2018年11月对244家社区卫生服务中心的行政负责人及4 047名在社区卫生服务中心工作的全科医生采用自行设计的问卷,通过问卷星网络发放进行问卷调查。 结果 上海城区社区卫生服务中心眼科、耳鼻喉科医生的比例高于郊区(62.82%vs. 33.13%,60.26%vs. 30.12%,均P<0.05),郊区儿科医生的比例高于城区(34.94%vs. 20.51%,P<0.05);城区全科医生对耳鼻喉科疾病(56.15%vs. 51.87%)、儿科疾病(81.46%vs. 66.60%)、皮肤科疾病(23.83%vs. 19.08%)的转诊比例高于郊区(均P<0.05),而郊区全科医生对妇科疾病转诊比例高于城区(79.40%vs. 74.61%,P<0.05);城区全科医生在慢病管理预约(82.55%vs. 77.47%)、心理疏导(73.83%vs. 66.45%)和营养咨询(72.59%vs. 61.57%)方面提供的服务比例多于郊区全科医生(均P<0.05)。 结论 上海市社区卫生服务中心全科医生对专科疾病诊疗行为存在城郊差异,其原因可能由于专科医生比例的差异,对专科疾病诊疗能力的不自信,卫生资源分布与发展不均衡等。在今后社区全科医师继续教育中应增加相关专科疾病的内容。
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| 关 键 词： | 全科医生 专科疾病诊疗 城乡差异 |
| 收稿时间： | 2020-02-03 |
Study on the current situation of the diagnosis and treatment of specialist diseases by general practitioners in Shanghai |
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| Affiliation: | Department of General Practice,Yangpu Hospital,Tongji University School of Medicine,Shanghai 200090,China |
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| Abstract: | Objective To understand the current situation of general practitioners' diagnosis and treatment of specialized diseases in Shanghai Community Health Service Center by means of questionnaire survey, and to provide direction for the continuing education of community general practitioners in order to improve the clinical quality of community general medicine and further promote the development of general medicine. Methods In November 2018, the administrators of 244 community health service centers and 4 047 general practitioners working in community health service centers were distributed through the questionnaire star network using a self-designed questionnaire. Results The proportion of doctors in ophthalmology(62.82% vs. 33.13%, P<0.05) and otolaryngology(60.26% vs. 30.12%, P<0.05) in urban areas was higher than that in suburbs, and the proportion of pediatricians in suburbs was higher than that in urban areas(34.94% vs. 20.51%, P<0.05). The referral rates of otorhinolaryngologic diseases(56.15% vs. 51.87%), paediatric diseases(81.46% vs. 66.60%), dermatology diseases(23.83% vs. 19.08%) in urban areas were higher than those in suburban areas(all P<0.05), while the referral rate of gynecological diseases in suburb was higher than that in urban area(79.40% vs.74.61%, P<0.05). The proportion of services provided by urban general practitioners was higher than that provided by suburban general practitioners in chronic disease management appointments(82.55% vs. 77.47%, P<0.05), psychological counseling(73.83% vs. 66.45%, P<0.05) and nutritional counseling(72.59% vs. 61.57%, P<0.05). Conclusion General practitioner of Shanghai Community Health Service Center have urban-rural differences in the diagnosis and treatment behavior of specialized diseases, which may be due to the difference in the proportion of specialized doctors, the lack of confidence in the ability of diagnosis and treatment of specialized diseases, and the uneven distribution and development of health resources. In the future, the contents of related specialized diseases should be add to the continuing education of community general practitioners. |
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