徐州市康复医疗资源现状与患者居家康复护理需求的调查分析

目的:了解徐州市康复医疗资源现状和患者居家康复护理需求的影响因素,为实施患者居家康复提供依据。方法:于2018年10—12月采用普查的方式调查徐州市所有的康复医疗机构(包括康复专科医院、设有康复科的综合医院、社区医疗卫生服务机构),采取实地走访与问卷调查相结合的方法对徐州市康复专科医院进行现状调查,调查内容包括康复医疗专业人员状况、专业类别等。同时在徐州市选取411例需要康复的患者进行调查,调查内容包括患者的基本情况和患者的康复需求状况、家庭医生签约服务状况等。采用Logistic回归分析影响居家康复护理需求的影响因素。结果:徐州市共有康复医疗卫生机构120所,床位量为2675张,床位数占应配备数的57.98%(2675/4314);现有康复医师402名,康复护士432名,康复治疗师808名,分别占规划的31.07%(402/1294)、16.69%(432/2588)和31.22%(808/2588)。30.90%(127/411)被调查的康复患者与社区医生进行了签约,且其中45.67%(58/127)的签约者对社区医生的服务感到不满意,满意率只有18.90%(24/127)。患者年龄(OR=0.557)、既往疾病是否存在偏瘫(OR=1.520)、社区医生数量(OR=1.131)是影响家庭医生签约的因素;其中年龄越小,签约程度越好,而存在偏瘫和社区医生数量增加是签约增加的因素。结论:徐州市康复医疗资源的配置还不能满足人民群众的需求,康复医疗资源配置不足体现在康复人才较少、康复医疗机构和康复设备不足等方面,家庭医生签约服务率也处在较低水平,实施居家康复项目仍存在很大的困难。

Rehabilitation resource and rehabilitation nursing needs of patients at home in Xuzhou

Objective To explore the current situation of rehabilitation resource and the influencing factors of rehabilitation nursing needs of patients at home in Xuzhou so as to provide a reference for home rehabilitation for patients.Methods From October 2018 to December 2018,this study investigated all rehabilitation medical institutions(rehabilitation specialized hospitals,general hospitals with Rehabilitation Department,community health service institutions)in Xuzhou City by general investigation.Rehabilitation specialized hospitals in Xuzhou were investigated with the method of field visit and questionnaire survey,and the investigation content included the situation and professional categories of rehabilitation professionals.At the same time,totals of 411 patients with the needs for rehabilitation in Xuzhou were investigated,and the investigation content included the basic situation,rehabilitation needs of patients,contract service by family doctors.This study also analyzed the influencing factors of home rehabilitation nursing needs by Logistic regression.Results There were 120 rehabilitation medical institutions in Xuzhou City.The bed number was 2675 accounted for 57.98%(2675/4314)of the bed number shall be equipped with.There were 402 rehabilitation physicians,432 rehabilitation nurses and 808 rehabilitation therapists respectively occupied 31.07%(402/1294),16.69%(432/2588)and 31.22%(808/2588)of the planning.There were 30.90%(127/411)of rehabilitation patients signed a contract with community doctors,and 45.67%(58/127)of them dissatisfied with community doctors service and the satisfaction rate was 18.90%(24/127).The influencing factors of family doctor contract included the ages of patients(OR=0.557),history of hemiplegia(OR=1.520)and the number of community doctors(OR=1.131).The young the ages were,the better the contract degrees were.The factors promoted the contract were hemiplegia and increasing in the number community doctors.Conclusions In Xuzhou,the rehabilitation medical resource allocation cannot meet the needs of the masses.The insufficient rehabilitation medical resource allocation reflected in the lack of rehabilitation talents,rehabilitation medical institutions and rehabilitation equipment.The rate of family doctors contract service was in the low level,and there are still great difficulties in the home rehabilitation.