摘要
目的调查上海市三大远郊区域社区卫生服务中心腹膜透析技术开展现状,分析存在问题,并提出建议。方法2024年3月-5月,对A区、B区、C区3个区域关键知情人进行问卷调查和半结构访谈。结果A区形成了“三级医院-二级医院-社区卫生服务中心”对口支援模式,B区形成了“医院-社区卫生服务中心-家庭”三位一体综合管理模式,C区形成了由三级医院直接对接社区下沉适宜技术的模式。3个区试点社区卫生服务中心均设有肾脏内科专科门诊,但均未建立信息化平台。B区和C区落实了社区门诊大病医保结算,A区在社区护理病房开展腹膜透析技术。面临免费家庭随访增加社区成本且限制医护人员积极性、操作技能培训不足、宣传力度较小、居民认可度不高等困难。结论远郊区域腹膜透析技术下沉社区模式值得推广。未来需加强信息化建设,加大政策支持力度,创新社区护理病房服务模式,积累高质量真实世界证据,打造社区特色服务品牌。
Objective To investigate the current situation of peritoneal dialysis technology in three outer suburban community health centers in Shanghai,analyze the existing problems and put forward suggestions.Methods From March to May 2024,a questionnaire survey and semi-structured interview were conducted among key informants in A,B and C district.Results District A formed a pairing assistance mode of"tertiary hospital-secondary hospital-community health center",District B formed a three-in-one comprehensive management mode of"hospital-community health center-family",and District C formed a mode of direct docking of tertiary hospitals with community sinking appropriate technologies.There were nephrology clinics in the pilot communities of the three districts,but no information platform was established.District B and District C implemented the settlement of medical insurance for serious diseases in community outpatient clinic,and District A developed peritoneal dialysis to community nursing ward.Challenges were faced such as increased community costs and demotivated healthcare workers due to free home visits,inadequate training in operational skills,limited promotional efforts,and low recognition from residents.Conclusion The peritoneal dialysis technology sinking community mode in the outer suburbs is worth promoting.In the future,it is necessary to strengthen the information construction,increase policy support,innovate the service mode of community nursing ward,accumulate high quality real world evidence,and build a community characteristic service brand.
作者
许媛媛
吴韬
陈建俞
罗莉
沈波
XU Yuanyuan;WU Tao;CHEN Jianyu(Shanghai Medical Group Joint Management Development Center,Shanghai,200040,China;不详)
出处
《中国卫生质量管理》
2025年第2期83-87,共5页
Chinese Health Quality Management
基金
上海市卫生健康委员会2022年卫生政策研究课题(编号:2022HP47)。
关键词
腹膜透析
社区卫生服务中心
适宜技术
远郊区域
终末期肾病
分级诊疗
Peritoneal Dialysis
Community Health Centers
Appropriate Technology
Outer Suburban Areas
End-Stage Renal Disease
Hierarchical Diagnosis and Treatment
