上海市2017年烧伤医疗资源分布的横断面研究

目的调查上海市烧伤医疗资源的分布和特征。 方法采用横断面研究方法于2017年5月对上海市卫生与计划生育委员会登记在案、可开展烧伤救治的33家医院进行信访和电话访问，调查指标主要包括医院基本情况、烧伤专科设置情况、专职医护数量及职称分布、烧伤专科救治硬件设备配备情况以及2016年烧伤临床工作量。 结果33家登记单位中仅19家实际开展烧伤救治，18家分布在浦西，11家设有烧伤专科病区；在11家设有烧伤专科病区的医院中，医护比(112∶213)约等于1∶2，床护医比(350∶213∶112)约等于3∶2∶1。烧伤专职医师职称分布呈倒金字塔型(高级：中级：初级＝50∶43∶19)，专职护士职称分布呈金字塔型(高级：中级：初级＝23∶73∶117)，专职医技人员全市仅9人，主要为康复师和呼吸治疗师；烧伤专科设备较为完善，含翻身床45张、小儿大字床18张、悬浮床7张、呼吸机21台、监护仪102台、电动取皮刀16把、轧皮机24台。全年累计门诊总量约13.5万例，急诊总量约2.9万例，年均收治患者约4 800例次，手术量约4 700例次。 结论上海市烧伤救治医疗资源布局相对平衡合理，但部分辖区烧伤救治仍有待加强；烧伤救治专科人才较前略增，但仍存在数量偏少、结构不合理现象；救治任务繁重，仍有待加强烧伤急救网络建设和资源优化。

Cross-sectional investigation on the distribution of burn medical resources in Shanghai in 2017

ObjectiveTo investigate the distribution and characteristics of medical resources for burn victims in Shanghai. MethodsA cross-sectional study was conducted in May 2017 to make letters and telephone visits to 33 burn treatment hospitals registered by shanghai municipal heath and family planning commission, which can carry out burn treatment. The investigation indexes included the basic situation of the hospital, burn surgery settings, doctors and nurses number and distribution characteristics, specialist equipments for burns, and burn casualties in 2016. ResultsOnly 19 of the 33 registered units actually carried out burn treatment, 18 of which were distributed in Puxi district and 11 of which had burn specialties. In these 11 burn-specialty settings hospitals, the doctor-to-nurse ratio was about 1∶2(112∶213), and the bed-to-doctor ratio was about 3∶2∶1 (350∶213∶112). The distribution of professional titles of full-time doctors was inverted pyramid (senior: intermediate: primary=50∶43∶19), full-time nurses distributed pyramid (senior: intermediate: primary=23∶73∶117), but there were only 9 full-time technicians in burn unit in the whole city, including rehabilitation and respiratory therapists mainly. The burn department in Shanghai were relatively well-equipped, including 45 turn-over beds, 18 scarecrow-type beds for burned children, 7 medical suspension beds, 21 ventilators, 102 ECG monitors, 16 motor dermatomes and 24 drum skin grafting machines. The total number of outpatient clinics, emergency departments , annual hospitalization and operation volum was about 135 000, 29 000, 4 800 and 4 700 respectively. ConclusionThe distribution of medical resources for burn treatment in Shanghai is relatively balanced and reasonable, but the burn surgery in some districts still needs to be strengthened; the number of specialists in burn treatment is slightly increased, but the number and structure of specialists are still few and unreasonable; the task of treatment is arduous, and the construction of emergency network for burn treatment and the optimization of medical resources are still to be strengthened.