上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（卫生事业管理） • 上一篇    下一篇

上海临终关怀机构卫生资源及服务现状的调查与分析

龚震晔1，陈立今2   

  1. 上海交通大学  医学院 1.附属瑞金医院院长办公室， 上海 200025； 2.院长办公室， 上海 200025
  • 出版日期:2013-08-28 发布日期:2013-09-16
  • 通讯作者: 陈立今, 电子信箱: clj@shsmu.edu.cn。
  • 作者简介:龚震晔（1974—）， 女， 副研究员， 硕士; 电子信箱: gzy30315@rjh.com.cn。

Survey and analysis of health resources and service situation in hospice care institutions in Shanghai

GONG Zhen-ye1, CHEN Li-jin2   

  1. 1.Dean's Office, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China; 2.President Office, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2013-08-28 Published:2013-09-16

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摘要：

目的 调查并分析上海市临终关怀医疗机构的卫生资源及服务现状。方法 选择上海市2家注册的临终关怀医疗机构（浦东新区老年医院和闸北区临汾路街道社区卫生服务中心）和1家有社会资助的临终关怀机构（新华医院宁养中心），采用结构式问卷调查与专家访谈相结合的方法进行调查。调查内容主要包括医疗机构硬件配置、人员配置、服务利用和经营情况，并收集各类人员对临终关怀的认知及建议。结果 被调查的2家临终关怀机构共有临终关怀专用病床48张，另外1家不设专用床位仅提供上门巡诊服务。从事临终关怀服务的执业医师30人，占执业医师总数的3.42%；注册护士40人，占注册护士总数的2.97%。晚期恶性肿瘤患者645人（占总出院人数的34.44%），人均住院时间52.33 d，人均医疗费用为4 620.32元，每人日均医疗费用为108.87元。3家医疗机构中均开展了心理护理指导咨询服务，也建立了志愿者队伍，但人员招募困难，志愿者服务工作不具有连贯性和长期性。结论 上海市的临终关怀服务尚未形成体系网络和模式，在加强临终关怀服务学科建设和人才培养的同时，应该倡导社会对临终关怀服务的重新认识，为尽快开展临终关怀服务确立法制依据并提供法律支持。

关键词: 临终关怀, 卫生资源, 服务现状

Abstract:

Objective To investigate the health resources and service situation in hospice care institutions in Shanghai. Methods Two registered hospice care institutions (Geriatric Hospital of Pudong New District and Linfen Road Community Health Service Center of Zhabei District) and one social-funded hospice care institution (Hospice Care Center of Xinhua Hospital) in Shanghai were selected, structured questionnaire and expert consultation were employed for survey, which mainly concerned with equipment, staff, service utilization and management of the institutions, and recognition and suggestions of different people were collected. Results There were 48 appropriative sickbeds in two registered hospice care institutions, and the other one only provided door-to-door outreach clinic services instead of setting up sickbeds. Thirty doctors were engaged in hospice care service, accounting for 3.42% of total doctors, and there were 40 registered nurses, accounting for 2.97% of total nurses. Terminal cancer patients (n=645) accounted for 34.4% of total discharged patients, the average duration of hospital stay was 52.33 d, the average medical cost during hospital stay was 4 620.32 yuan per patient, and the average daily medical cost was 108.87 yuan per patient. Psychological nursing was conducted in all the three institutions, and volunteers were recruited, though the volunteer service was less consistent. Conclusion The hospice care service in Shanghai has not yet formed a systemic network and mode. Along with strengthening the construction of hospice service and personnel training, the notion of hospice care service should be enhanced, which may help to establish the legal support for hospice care service as soon as possible.

Key words: terminal care, health resources, service situation