我国基层医生社区康复服务能力现状与对策研究  

Research on Current Situation and Countermeasure of Chinese Primary Care Physicians'Community Rehabilitation Service Ability

作　　者：练璐 王敌 陈家应 刘武 LIAN Lu;WANG Di;CHEN Jiaying;LIU Wu;无(Department of Operations Management,Jiangsu Province Hospital/the First Affiliated Hospital with Nanjing Medical University/Jiangsu Women and Children Health Hospital,Nanjing 210029,China;Department of Organization and Human Resources,Jiangsu Province Hospital/the First Affiliated Hospital with Nanjing MedicalUniversity/Jiangsu Women and Children Health Hospital,Nanjing 210029,China;School of Humanities and Management,Kangda College of Nanjing Medical University,Lianyungang 222000,China;Department of Discipline Inspection,Jiangsu Province Hospital/the First Affiliated Hospital with Nanjing Medical University/Jiangsu Women and Children Health Hospital,Nanjing 210029,China)

机构地区：[1]江苏省人民医院南京医科大学第一附属医院江苏省妇幼保健院运营管理处,江苏省南京市210029 [2]江苏省人民医院南京医科大学第一附属医院江苏省妇幼保健院组织人事处,江苏省南京市210029 [3]南京医科大学康达学院人文与管理学部,江苏省连云港市222000 [4]江苏省人民医院南京医科大学第一附属医院江苏省妇幼保健院纪委办公室,江苏省南京市210029

出　　处：《中国全科医学》2025年第4期450-456,共7页Chinese General Practice

基　　金：国家自然科学基金面上项目(71874087)。

摘　　要：背景“康复回社区”是形成合理就医格局的重点要求,也是实现人人享有康复服务的重要策略,但目前我国基层医生的社区康复服务能力与居民日益增长的康复需求仍有差距。目的了解我国基层医生社区康复服务能力的现状、特点与不足,为制定能力提升对策提供科学依据。方法2020年8月采用多阶段分层抽样与典型抽样相结合的方法对中国江苏省、安徽省、河南省、重庆市、甘肃省五地基层医疗卫生机构的医生开展问卷调查,从康复功能评定、康复医疗服务、中医药保健指导、中医理疗四个方面调查基层医生社区康复服务能力现状。结果共回收8374份问卷,接受调查的基层医生中,分别有4697名(56.1%)、6396名(76.4%)、5833名(69.7%)、4834名(57.7%)具备康复功能评定、康复医疗服务、中医药保健指导、中医理疗能力,且农村地区基层医生各项社区康复能力及综合能力具备率均高于城市地区(P<0.05)。不同年龄、学历、执业资格、岗位基层医生的康复医疗服务指导、中医药保健指导、中医理疗能力具备率比较,差异有统计学意义(P<0.05);组内两两比较结果显示,在年龄方面,30岁以下及60岁以上基层医生康复功能评定能力的具备率高于30~<45岁、45~<60岁(P<0.016),45~<60岁医生具备率高于30~<45岁(P<0.016),45岁以下的康复医疗服务指导能力具备率低于45岁以上的基层医生(P<0.016);30岁以下基层医生中医药保健指导、中医理疗能力具备率低于30~<45岁、45~<60岁和60岁以上(P<0.016),30~<45岁医生能力具备率低于45~<60岁和60岁以上(P<0.016),45~<60岁医生具备率低于60岁以上(P<0.016)。在学历方面,高中/中专及以下学历基层医生能力具备率高于大专学历和本科学历(P<0.016),大专学历医生能力具备率高于本科学历(P<0.016)。在执业资格方面,全科医师具备率高于乡村医师和执业(助理)医师(P<0.016),乡村医师具�Background With the promotion of"strengthening the primary health"measures,the number of primary health professionals in China has increased significantly,but there is still a gap between the ability of primary care physicians and basic medical needs of residents.Objective To understand the current situation,characteristics and deficiencies of Chinese primary care doctors'community rehabilitation service ability,so as to provide scientific basis for making countermeasures to improve ability.Methods The method of multi-stage stratified sampling combined with typical sampling was adopted to carry out an online questionnaire survey on doctors in primary health institutions in Jiangsu province,Anhui province,Henan province,Chongqing City and Gansu province.The current situation of community rehabilitation service ability of primary care physicians was evaluated from four aspects:rehabilitation function evaluation,rehabilitation medical service,traditional Chinese medicine health guidance and traditional Chinese medicine physiotherapy.Results A total of 8374 questionnaires were analyzed.Among the primary doctors surveyed,4697 cases(56.1%),6396 cases(76.4%),5833 cases(69.7%)and 4834 cases(57.7%)were equipped with the ability of rehabilitation function assessment,rehabilitation medical services,TCM health guidance and TCM physiotherapy,respectively.Moreover,the abilities of primary doctors in rural areas were better than that in urban areas,and the difference was statistically significant(P<0.05).There were statistically significant differences in the rates of rehabilitation medical service guidance,traditional Chinese medicine health care guidance and traditional Chinese physiotherapy ability of primary doctors in different ages,educational qualifications,and positions(P<0.05).The pairwise comparison results showed that in terms of age.In terms of assessment ability of rehabilitation function,doctors under 30 years old and over 60 years old had a higher rate than those 30-<45 years old and 45-<60 years old(P<0.016),and

关 键 词：初级卫生保健 基层医生 社区康复 分层分析 城乡地区 

分 类 号：R161[医药卫生—公共卫生与预防医学]