《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (06): 634-641.

• 特稿 • 上一篇    下一篇

出院计划的国际实施进展及认识

唐丽 1,2,李建军 1,2,高峰 1,2,杨明亮 1,2,杜良杰 1,2,Sheila Purves3,黄卫平 3   

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-25 发布日期:2015-06-25

International Progress and Understanding of Discharge Planning

TANG Li1,2, LI Jian-jun1,2, GAO Feng1,2, YANG Ming-liang1,2, DU Liang-jie1,2, Sheila Purves3, HUANG Wei-ping3   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China; 2. Department of Spinal and Neural Function Reconstruction, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China; 3. The Hong Kong Society for Rehabilitation -WHO Callaboration Center for Rehabilitation, Hong Kong, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-25 Online:2015-06-25

摘要: 随着社会经济的发展和医疗服务模式的转变,为患者提供连续协调的健康服务、实现各医疗服务机构之间的无缝衔接,即连续医疗服务,成为一种必然趋势。出院计划以患者为中心,以患者需求为导向,在患者及家属积极参与及配合下,通过多学科、多机构之间的协调合作,从而保障连续医疗服务的顺利实施。本文分析了美国、加拿大、巴西、英国、爱尔兰、澳大利亚、日本、印度、南非以及中国香港、台湾和大陆等国家和地区出院计划产生的背景及发展现状,当出现医疗负担过重、老龄化加剧、医疗服务供需不均衡等问题时,出院计划应运而生,旨在合理使用医疗资源、节约医疗服务成本、保证连续性医疗服务的质量,避免出院后不良事件的发生,并提高患者功能与生活质量。通过参考各国出院计划指南,本文就出院计划实施小组、时间与机构、流程等方面进行综述,为我国出院计划服务的发展提供参考。

关键词: 出院计划, 连续医疗服务, 康复

Abstract: With the social development and the transformation of medical model, providing patients with continuous services and seamless transfer between different medical institutions, namely continuity care, is inevitable. Discharge planning take patients as the center and patient's needs as the guidance. Patients and their families should actively take part in the plan. Through multi-disciplinary and multi-institutional cooperation, patients can continue to enjoy health services after discharge. Discharge planning is the basis of continuous medical service. This article summrized the background and situation of discharge planning in the United States, Canada, Brazil, the United Kingdom, Ireland, Australia, Japan, India, South Africa, and Hong Kong, Taiwan and mainland in China. When heavy medical burden, aging, imbalence between supply and demand occurred, discharge planning could be helpful to make rational use of medical resources, save medical costs, guarantee the quality of medical service continuity, avoid the occurrence of adverse events after discharge and improve the patients' function and quality of life. This article reviewed group members, time, institutions and process of discharge planning in order to provide evidence-based basis for the development of discharge planning in China.

Key words: discharge planning, continuity of healthcare, rehabilitation