上海市浦东新区注册临终关怀机构卫生资源和服务现状分析

摘要

Objective: To investigate and analyze the health resources and service situation of the hospice care institutions in Pudong New District of Shanghai. Methods:A structure questionnaire survey approach was taken to investigate the hospice care resources and service situation of 2 registered hospice care medical institutions in Pudong New District of Shanghai, whose survey contents included the hardware conifguration, stafifng, utilization of service resources and operation of the medical institutions. Results: There were 20 hospice care sickbeds in the 2 investigated hospice institutions, which accounted for 5.00% of the total approved sickbeds. The practicing physicians accounted for 2.00% of the total numbers of the employees, and the registered nurses 3.32%. The volunteers and care workers also participated in the hospice care. The died patients in the hospice care wards were 71, accounting for 47.97%of the total number of the discharged patients from the hospice care departments. The top ifve diseases of the patients discharged from the institutions were lung cancer, colon cancer, stomach cancer, liver cancer, and cardiovascular and cerebrovascular diseases. The using ratio of the hospice care sickbeds was 46.93%in two medical institutions and the average length for the hospital care was 28.48 days per person. Conclusion:The hospice service conifguration has been initially formed in 2 medical institutions which can provide the related hospice care service. However, there exit low bed utilization rate, the shortage of service personnel and operating funds and other issues. Based on strengthening the construction of the discipline and personnel training of the hospice care, the promotion and awareness of the hospice care should be strengthened.%目的：调查并分析上海市浦东新区临终关怀医疗机构的卫生资源与服务现状。方法：采用结构式问卷调查方法，调查上海市浦东新区2所注册的临终关怀医疗机构（上海市浦东新区老年医院和迎博社区卫生服务中心）临终关怀资源及服务情况。调查内容包括医疗机构硬件配置、人员配置、服务利用及运营状况。结果：被调查的2所临终关怀机构共有临终关怀病床20张，占核定总床位的5.00%。执业医师占职工总数2.00%，注册护士占3.32%，志愿者和护工也参与临终关怀工作。临终关怀病房死亡患者为71人，占临终关怀科出院总人数的47.97%。出院患者中前5位疾病为肺癌、肠癌、胃癌、肝癌、心脑血管疾病。2所医疗机构平均病床使用率为46.93%，人均住院天数为28.48 d。结论：2所医疗机构的配置已初步形成，能提供相应的临终关怀服务，但同时存在床位使用率低，医务人员紧缺，运营资金紧张等问题。在加强临终关怀服务学科建设和人员培养的基础上，应加强临终关怀的推广和认识。