综合性医院全科医学科学科建设和科室设立的基层需求研究  

Needs and requirements for general practice department in general hospitals from the perspective of grassroots: a qualitative study

作　　者：郝立晓[1] 曹若瑾[1] 刘川[1] 贾建国[1] Hao Lixiao;Cao Ruojin;Liu Chuan;Jia Jianguo(Department of General Practice,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院全科医学科,北京100053

出　　处：《中华全科医师杂志》2022年第4期343-348,共6页Chinese Journal of General Practitioners

摘　　要：目的探讨综合性医院全科医学科学科建设及科室设立的基层需求,为进一步完善学科建设提供建议。方法2020年7月1日至2022年2月15日,通过目的抽样法,依据纳入标准选取北京、西安及广州市3地人员作为研究对象,按照访谈提纲就综合性医院全科医学科学科建设及科室设立的基层需求分别进行个人深入访谈。结果28名访谈对象提出了建议,提炼如下:(1)设立全科医学科具有必要性:综合性医院设立全科医学科具有自身优势;满足基层社区的医疗需求;全科诊疗思维的建立是其教学工作的重点;对科研培训需求相对较少。(2)与社区教学基地协作:加强联合教学查房及联合出诊可以促进综合性医院全科医学科与基层教学基地有效协作,临床基地与基层基地师资同质化是二者有效协作的基础。(3)社区有培训需求:合理用药是目前社区医生对综合性医院全科医学科提出的较大培训需求;开展亚专科知识培训也有需求。(4)科室设立的要求:除具备完整的组织架构外,日常教学工作需落到实处,增加与外界的横向及纵向联络;带教考核指标需在综合性医院全科医学科绩效考核中占较大比例;全科医学科需具备过硬的临床业务能力帮助社区转诊。结论基层对综合性医院全科医学临床、教学及科研方面具有不同的培训需求,联合教学查房和联合出诊以及保证师资同质化可以促进协作,合理用药及亚专科培训是未来全科医学科培训的重点,具备完整的组织架构、网络连接以及过硬的临床基本功、带教在科室绩效考核中的占比提升是对综合性医院全科医学科提出的科室设立要求。Objective To survey the needs and requirements of the general practice department in general hospitals from the perspective of grassroots health care personnel.Methods From July 2020 to February 2022,a qualitative study on needs and requirements for the general practice department in general hospitals was conducted.Twenty eight participants from community health service centers in Beijing,Xi′an and Guangzhou were selected for the in-depth interviews.Results The participants expressed their opinions and suggestions on the community needs and requirements for general practice department in general hospitals as follows.(1)The necessity of establishing department of general practice in general hospitals:the general hospitals had advantages to meet the medical needs of the community;the teaching and training should be focus on the way of thinking in the general practice,while the training needs for research ability was less required.(2)The cooperation between general hospital and its community teaching base:to implement the joint teaching rounds and joint home visits were effective ways for collaboration,which may ensure the quality of clinical faculty in the community bases.(3)The training needs of the community:rational use of drugs was most required,sub-specialty training was another concern for general practitioners in grassroots level.(4)The requirements for general practice department in the general hospital:in addition to complete organizational structure,daily teaching work needs to be implemented,and horizontal and vertical connection to relevant health institutions also need to be strengthened.Meanwhile,the teaching work should be a considerable part in the department performance assessment,and excellent clinical ability was also required to facilitate the effective referral of patients from the community.Conclusions The study shows the necessity of establishing department of general practice in general hospitals,and various needs from the community teaching base,which providing reference for improving the

关 键 词：医院 综合 卫生服务需求 定性研究 全科医学 

分 类 号：R197.323[医药卫生—卫生事业管理]