首页> 中文期刊> 《中国全科医学》 >分层互补适宜卫生技术在单病种医疗协同体内推广效果调查

分层互补适宜卫生技术在单病种医疗协同体内推广效果调查

摘要

Objective To investigate the promotional effectiveness and suitability of stratified complementary appropriate health technology( AHT)in single - disease synergy medical system and to lay a foundation for the research of operation mechanism of single - disease synergy medical system. Methods Using typical sampling method,we enrolled 12 doctors from the county - level hospitals and five rural health centers in COPD synergy medical system and 21 doctors from the county - level hospitals and five rural health centers in child bronchial asthma synergy medical system. In December 2014,we employed self - made questionnaire to conduct survey. The survey content included general information,the evaluation of training necessity and training effect for appropriate health technology,the mastery of appropriate health technology,the application of appropriate health technology and the evaluation of suitability of appropriate health technology. A total of 33 questionnaires were distributed,and 33 effective questionnaires were returned,with an effective returning rate of 100. 0% . Results Of the 12 subjects of COPD synergy medical system,10(83. 3% )thought the training was very necessary,and 2(16. 7% )thought the training was necessary;9(75. 0% )thought the training effect was very good,and 3(25. 0% ) thought the training was good. Of the 21 subjects of child bronchial asthma synergy medical system,18 ( 85. 7% ) thought the training was very necessary,2( 9. 5% ) thought the training was necessary and 1 ( 4. 8% ) thought the training was barely necessary;5 (26. 3% )thought the training effect was very good,11(57. 9% )thought the training was good,and 3(15. 8% )thought the training effect was barely good(results of 2 subjects were missing). The median score of COPD appropriate health technology was 5. 0 - 8. 0,and the median score of appropriate health technology for child bronchial asthma was 4. 8 - 6. 0. The scores of technology safety,diagnosis,therapeutical effect,economical efficiency and acceptability were 8. 0 - 10. 0,7. 0 - 9. 0,3. 5 -9. 0 and 6. 5 - 9. 0. Conclusion The promotional effectiveness and suitability of stratified complementary appropriate health technology in single - disease synergy medical system are good. However,the mastery degree of appropriate health technology is different among doctors of primary care,the application of technology needs to be further promoted,and the level of diagnosis and treatment in primary care medical settings in synergy medical system needs to be improved significantly.%目的:了解分层互补适宜卫生技术在单病种医疗协同体内的推广效果及其适宜性,为研究单病种医疗协同体的运行机制奠定基础。方法采用典型抽样法,抽取慢性阻塞性肺疾病(COPD)医疗协同体内县级医院和5个乡镇卫生院的医生共12人、儿童支气管哮喘医疗协同体内县级医院和5个乡镇卫生院的医生共21人为调查对象。于2014年12月,采用自制调查问卷进行调查。调查内容包括:被调查医生的基本情况;对适宜卫生技术培训必要性、培训效果的评价;对适宜卫生技术的掌握情况、应用情况、适宜性的评价。共发放问卷33份,回收有效问卷33份,问卷的有效回收率为100.0%。结果 COPD 医疗协同体的12人中,分别有10人(占83.3%)、2人(占16.7%)认为培训非常必要、比较必要;分别有9人(占75.0%)、3人(占25.0%)认为培训效果非常好、比较好。儿童支气管哮喘医疗协同体的21人中,分别有18人(占85.7%)、2人(占9.5%)、1人(占4.8%)认为培训非常必要、比较必要、一般;分别有5人(占26.3%)、11人(占57.9%)、3人(占15.8%)认为培训效果非常好、比较好、一般(缺失2人)。被调查医生对 COPD 适宜卫生技术群的掌握程度评分中位数为5.0~8.0分;对儿童支气管哮喘适宜卫生技术群的掌握程度评分中位数为4.8~6.0分。各项技术的安全性、诊断或治疗效果、经济性、可接受性的评分中位数分别为8.0~10.0、7.0~9.0、3.5~9.0、6.5~9.0分。结论分层互补卫生适宜技术在单病种医疗协同体中推广效果较好,适宜性得到认可,但基层医生对适宜卫生技术掌握程度不一,技术应用有待加强,医疗协同体中基层医疗卫生机构诊疗水平提高任重道远。

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