【摘要】：目的:在充分挖掘康復(fù)醫(yī)療服務(wù)建設(shè)相關(guān)文獻資料的基礎(chǔ)上,了解康復(fù)醫(yī)療服務(wù)的發(fā)展歷程、國內(nèi)外研究現(xiàn)狀以及國家和廣東省為推進康復(fù)醫(yī)療服務(wù)能力建設(shè)所采取的政策措施,從而對國內(nèi)外在康復(fù)事業(yè)領(lǐng)域的研究能夠有全面的理解;通過開展調(diào)查研究廣州地區(qū)中醫(yī)院康復(fù)科建設(shè)情況,掌握廣州地區(qū)中醫(yī)院康復(fù)醫(yī)療服務(wù)開展基礎(chǔ)以及供給能力;使用數(shù)據(jù)包絡(luò)分析法對廣州地區(qū)中醫(yī)院康復(fù)醫(yī)療服務(wù)效率進行分析,找出效率存在的問題,提出有效提高康復(fù)醫(yī)療服務(wù)質(zhì)量和效率的建議。方法:1、采用文獻歸納法,系統(tǒng)歸納國內(nèi)外康復(fù)醫(yī)療服務(wù)開展的現(xiàn)狀和存在問題,分析和總結(jié)廣州地區(qū)康復(fù)醫(yī)療服務(wù)開展概況,從而更全面地認知康復(fù)醫(yī)療服務(wù),并為調(diào)查問卷、訪談提綱和測算指標(biāo)的選取奠定基礎(chǔ);2、采用問卷調(diào)查法,調(diào)查廣州地區(qū)22所二級及以上中醫(yī)醫(yī)院康復(fù)醫(yī)療服務(wù)開展情況;3、運用衛(wèi)生統(tǒng)計學(xué)方法,對調(diào)查問卷數(shù)據(jù)進行描述性統(tǒng)計分析和統(tǒng)計學(xué)檢驗;4、采用訪談法,依托廣東省中醫(yī)藥局平臺,利用座談會和個人訪談的形式,結(jié)合文獻研究資料,針對研究內(nèi)容設(shè)計訪談提綱,對涉及康復(fù)醫(yī)療管理和服務(wù)的相關(guān)專家進行訪談,訪談對象涵蓋醫(yī)院管理學(xué)專家、醫(yī)院管理層領(lǐng)導(dǎo)、康復(fù)科負責(zé)人以及康復(fù)專業(yè)人員,了解各位專家對提升康復(fù)醫(yī)療服務(wù)能力的意見和想法;5、運用數(shù)據(jù)包絡(luò)分析法對廣州地區(qū)中醫(yī)院康復(fù)醫(yī)療服務(wù)效率進行分析,分析效率存在的問題,提出有效提高康復(fù)醫(yī)療服務(wù)質(zhì)量和效率的建議。結(jié)果:廣州地區(qū)中醫(yī)院康復(fù)醫(yī)療服務(wù)能力存在以下問題:(1)康復(fù)科建設(shè)與管理制度不完善;(2)康復(fù)專業(yè)人才匱乏,尤其體現(xiàn)在康復(fù)治療師數(shù)量少,質(zhì)量低,康復(fù)科專業(yè)人員職稱結(jié)構(gòu)、學(xué)歷結(jié)構(gòu)等不合理;(3)康復(fù)設(shè)備配置不全面;(4)康復(fù)轉(zhuǎn)診開展力度不足,大部分上下級醫(yī)院未簽訂轉(zhuǎn)診協(xié)議,未能落實分級診療制度;(5)康復(fù)醫(yī)療項目醫(yī)保報銷比例低;(6)康復(fù)醫(yī)療服務(wù)效率有待提高,尤其是三級中醫(yī)醫(yī)院康復(fù)科規(guī)模偏大;(7)康復(fù)支出和康復(fù)設(shè)備投入冗余,康復(fù)科總診療人次和康復(fù)收入產(chǎn)出有待提高。結(jié)論:針對發(fā)現(xiàn)的存在問題建議從以下方面進行改善:(1)完善中醫(yī)醫(yī)院康復(fù)科建設(shè)與管理規(guī)范;(2)加大對康復(fù)專業(yè)人才的培養(yǎng)力度;(3)合理配置與利用康復(fù)醫(yī)療服務(wù)資源,提升康復(fù)醫(yī)療服務(wù)能力;(4)暢通雙向轉(zhuǎn)診渠道,逐步完善三級康復(fù)醫(yī)療服務(wù)體系;(5)完善康復(fù)醫(yī)療保障制度,爭取配套政策的支持;(6)控制康復(fù)科過快擴張,合理配置康復(fù)醫(yī)療資源,避免資源浪費,提高產(chǎn)出。
[Abstract]:OBJECTIVE: To understand the development history of rehabilitation medical service, the research status at home and abroad, and the policies and measures taken by the state and Guangdong Province to promote the rehabilitation medical service capacity building on the basis of fully tapping the relevant literature of rehabilitation medical service construction, so as to have a comprehensive understanding of the research in the field of rehabilitation at home and abroad. Through investigating and researching the construction of rehabilitation department in Guangzhou Traditional Chinese Medicine Hospital, grasping the basis and supply ability of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital; using data envelopment analysis method to analyze the efficiency of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital, finding out the existing problems of efficiency, and putting forward effective measures to improve the quality of rehabilitation medical service. Methods: 1. Adopting the method of literature induction, this paper systematically summarizes the current situation and existing problems of rehabilitation medical services at home and abroad, analyzes and summarizes the general situation of rehabilitation medical services in Guangzhou, so as to more comprehensively understand rehabilitation medical services, and lays a foundation for the selection of questionnaire, interview outline and measurement index; 2. Adopting the method of literature induction. Using questionnaire survey method, this paper investigates the development of rehabilitation medical services in 22 secondary and above hospitals of traditional Chinese medicine in Guangzhou area; 3. Using health statistics method, descriptive statistical analysis and statistical test of the questionnaire data; 4. Using interview method, relying on the platform of Guangdong Provincial Bureau of Traditional Chinese Medicine, using the form of Symposium and personal interview, combined with the text. Presents the research material, designs the interview outline according to the research content, carries on the interview to the related expert which involves the rehabilitation medical treatment management and the service, the interview object covers the hospital management expert, the hospital management leadership, the rehabilitation department responsible person as well as the rehabilitation specialized personnel, understands each expert to enhance the rehabilitation medical service ability the opinion and the idea; Data envelopment analysis (DEA) was used to analyze the efficiency of rehabilitation medical service in Guangzhou Traditional Chinese Medicine Hospital, and the existing problems were analyzed. Suggestions for improving the quality and efficiency of rehabilitation medical service were put forward. Professional personnel shortage, especially in the number of rehabilitation therapists, low quality, rehabilitation professionals Title structure, academic structure unreasonable; (3) rehabilitation equipment configuration is not comprehensive; (4) rehabilitation referral to carry out inadequate, most of the lower and upper hospitals have not signed referral agreements, failed to implement the classification of medical treatment system; (5) rehabilitation medical insurance projects Reimbursement rate is low; (6) Rehabilitation medical service efficiency needs to be improved, especially the scale of the rehabilitation department in the tertiary hospitals of traditional Chinese medicine is relatively large; (7) Rehabilitation expenditure and equipment input redundancy, the total number of patients in the rehabilitation department and the output of rehabilitation income need to be improved. Standardization of rehabilitation construction and management; (2) Enhancing the training of rehabilitation professionals; (3) Rationally allocating and utilizing the resources of rehabilitation medical services to enhance the ability of rehabilitation medical services; (4) Unobstructing the two-way referral channels, gradually improving the three-level rehabilitation medical service system; (5) Perfecting the rehabilitation medical security system, striving for the support of supporting policies; (6) Controlling the health The Department of rehabilitation should expand rapidly, rationally deploy rehabilitation medical resources, avoid waste of resources and increase output.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.4

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