中国康复理论与实践 ›› 2022, Vol. 28 ›› Issue (12): 1365-1379.doi: 10.3969/j.issn.1006-9771.2022.12.001

• 专稿 国家康复质控报告 • 上一篇    下一篇

2021年度国家康复医学专业医疗服务与质量安全报告

张元鸣飞,杨延砚,张娜,刘京宇,刘小燮,张之良,周谋望()   

  1. 国家康复医学专业医疗质量控制中心/北京大学第三医院康复医学科,北京市 100191
  • 收稿日期:2022-11-24 修回日期:2022-11-28 出版日期:2022-12-25 发布日期:2023-01-10
  • 通讯作者: 周谋望 E-mail:zhoumouwang@163.com
  • 作者简介:张元鸣飞(1991-),男,汉族,山西太原市人,博士,主治医师,主要研究方向:质控大数据、康复医工结合、超声介入。|周谋望(1960-),男,汉族,教授,博士研究生导师,主要研究方向:骨科与运动损伤康复、脊髓损伤康复、康复质控。

2021 National Report on Rehabilitation Medicine Services, Quality and Safety in Medical Care System

ZHANG Yuanmingfei,YANG Yanyan,ZHANG Na,LIU Jingyu,LIU Xiaoxie,ZHANG Zhiliang,ZHOU Mouwang()   

  1. National Center for Quality Management and Control of Rehabilitation Medicine/Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing 100191, China
  • Received:2022-11-24 Revised:2022-11-28 Online:2022-12-25 Published:2023-01-10
  • Contact: ZHOU Mouwang E-mail:zhoumouwang@163.com

摘要:

目的 从医疗机构康复医疗服务结构、环节、结局质量等方面,对2020年全国综合医院康复医学科、康复医院的医疗服务与质量安全进行分析。

方法 数据来源于国家医疗质量管理与控制信息系统,2021年度调查全国全部二级以上综合医院、康复医院,包含中医、中西医结合综合医院共9 138家2020年相关数据,其中2 676家抽样调查医院配置了康复医学病房,数据清洗后实际共纳入2 268家医院数据,进行康复医疗服务统计分析。并选取2017年至2020年均参与康复医学科调查表填报共6 336家医院进行康复医学科病房设置以及医疗服务质量分析。

结果 在2021年度报送数据9 138家综合医院中,仅2 676家设置有康复医学病房,其中委管委属综合医院中3家尚未设置病房。综合医院中,57.92%医院的平均每床配置医师数、80.44%医院的平均每床配置康复治疗师数、53.92%医院的平均每床配置护士数未达到国家要求,且各地区康复医学科每床平均配置康复医务人员数量差距较大。综合医院骨科、神经内科病房、重症医学科病房早期康复介入率分别为13.20%、18.90%、29.25%。综合医院康复医学科出院患者平均日常生活活动能力(ADL)改善率为76.35%,康复专科医院出院患者ADL改善率为64.30%。

结论 我国康复医学专业医疗服务与质量安全整体稳中有升,同质化程度进一步加强。目前存在的突出问题:2020年全国多数综合医院未配置康复医学科病房,且全国康复医务人员总量不满足要求、分布不均;康复早期介入不足,康复治疗效果尚有提升空间。

关键词: 康复医学, 医疗服务, 质量安全, 质量控制

Abstract:

Objective To describe the medical services, quality and safety of rehabilitation medicine departments in general hospitals and rehabilitation hospitals in 2020 from the aspects of structure, link and outcome quality.

Methods Through the National Clinical Improvement System of the National Health Commission, all secondary and above general hospitals and rehabilitation hospitals were investigated in 2021, the relevant data from 9 138 hospitals, including traditional Chinese Medicine hospitals and integrated traditional Chinese and Western medicine hospitals in 2020. A total of 2 676 sampling hospitals were equipped with rehabilitation medicine wards. After cleaning, a total of 2 268 samples of hospitals were included for analysis. Then, the setting of wards of rehabilitation medicine departments in 6 336 hospitals that participated in the questionnaire of rehabilitation medicine departments from 2017 to 2020 was analyzed.

Results Among the 9 138 general hospitals surveyed this year, only 2 676 had rehabilitation wards, and three general hospitals administrated to National Health Commision had not yet set up wards. In general hospitals, the average number of physicians per bed in 57.92% hospitals, the average number of rehabilitation therapists per bed in 80.44% hospitals, and the average number of nurses per bed in 53.92% hospitals did not meet the national requirements, and the average number of rehabilitation medical personnel per bed in rehabilitation medicine departments in different regions was significantly different. The rates of early rehabilitation intervention were 13.20%, 18.90% and 29.25% respectively in the department of orthopedics, department of neurology and department of intensive care in general hospitals. The average activity of daily living improvement rate of discharged patients from rehabilitation department of general hospital was 76.35%, and that of discharged patients from rehabilitation specialized hospital was 64.30%.

Conclusion Professional medical services and quality safety of rehabilitation medicine in China improve steadily, and the degree of homogenization is further strengthened. However, from the perspective of the current prominent problems, in 2020, most general hospitals in China have not configured the wards of rehabilitation medicine, and there are problems such as the total number of rehabilitation medical personnel in the country does not meet the requirements, uneven distribution, insufficient early intervention in rehabilitation, and room for improvement of rehabilitation treatment effect, which need continuous improvement.

Key words: rehabilitation medicine, medical services, quality and safety, quality control

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