摘要
目的分析三级康复网络下以患者为中心的半淞园社区闭环康复体系患者准入准出标准实际运行情况及临床收治数据和最终康复效果,以挖掘问题和不足、分析原因和成因、提出建议和对策,加快其社区康复医学科建设发展的步伐。方法采集自2020年3月10日往前追溯符合收治范围的100例患者临床数据(脑卒中和骨骼肌肉系统疾病各50例),包括患者基本信息、临床诊断、临床治疗,将其与计划的《社区常见疾病康复对象分级康复准入准出标准》进行比较分析,以评价本机构康复医学科服务运行的严密性、与计划之间的一致性、最终的服务结果。结果进入社区康复体系的患者均未再进行传统的全面检查,尤其是涉及医疗收费的项目,社区康复体系更关注既往病史的收集、康复功能的评定,但康复功能评定中,原计划开展的言语功能评估未落实;治疗方案中,使用频次最高的技术,在重人工操作和重设备治疗项目上,均有分布;治疗结果上,使用自行建立的评价体系,脑卒中功能恢复及提高占比为68.2%,骨骼肌肉系统疾病症状消除及减轻占比为91.9%。结论半淞园社区康复医学科做到了服务运行的严密性、按计划收治的一致性、服务结果的有效性,康复医学科在保证良好效果的同时,通过务实创新,省去了不必要的重复检查,升级了更关注患者症状、更适合社区的指标,充分体现了社区康复的以人为本、注重实效、严格控费等特征,但后期需对替代性指标进行科学研究,以形成有梯度、有明确定义、有统一标准化测量方式、与金标准可溯源的评价体系,切实保证临床服务质量的同质性。
Objective To analyze the actual operation of the patient entry and exit criteria in the patient-centered Bansongyuan community closed-loop rehabilitation system under the three-level rehabilitation network, as well as clinical admission data and final rehabilitation results, so as to excavate and sort out Bansongyuan community operation as the earliest institution in Shanghai to implement closed-loop community rehabilitation management under the three-level rehabilitation network for accelerating the pace of construction and development of its community rehabilitation medicine department. Methods The clinical data of 100 patients(including 50 cases of stroke and 50 cases of musculoskeletal disorders) retrospectively within the scope of treatment from March 10, 2020 onwards were collected, including basic patient information, clinical diagnosis, clinical treatment. And it was compared with the planned Community Common Disease Rehabilitation Objects Grading Rehabilitation Access Admission Standard to evaluate and analyze the rigor of the service operation, the consistency with the plan, and the final service result of the Rehabilitation Medicine Department of the institution. Results None of the patients who entered the community rehabilitation system underwent traditional comprehensive examinations, especially those involving medical charges. The community rehabilitation system paid more attention to the collection of past medical history and the assessment of rehabilitation function. However, in the rehabilitation function assessment, the originally planned verbal function assessment was not implemented;the most frequently used techniques in the treatment plan are distributed in heavy manual operation and heavy equipment treatment projects;in the treatment results, the self-established evaluation system was used, and stroke function recovery and improvement accounted for 68.2%, and skeletal and muscular system disease symptom elimination and reduction accounted for 91.9%. Conclusion Bansongyuan Community Rehabili
作者
张辉
金迎
薛文婕
胡漪清
徐霄
曹晓颖
ZHANG Hui;JIN Ying;XUE Wen-jie;HU Yi-qing;XU Xiao;CAO Xiao-ying(Huangpu District Bansongyuan Community Health Service Center,Shanghai 200011)
出处
《智慧健康》
2021年第17期38-42,共5页
Smart Healthcare
基金
上海市黄浦区科委项目:以患者为中心的社区卫生康复服务体系建立与分级诊疗模式探索(项目编号:HKW201804)
上海市中西医结合学会社区医学与健康管理研究项目:基于信息化的康复中心-社区卫生服务中心康复服务体系探索与实践研究(项目编号:2018SQ006)。
关键词
社区康复医学
三级康复网络
核心指标
评价
Community rehabilitation medicine
Three-level rehabilitation network
Core indicators
Evaluation
