PDF下载

[1]许媛媛吴韬陈建俞罗莉沈波.上海市远郊社区卫生服务中心腹膜透析技术开展现状调查与分析[J].中国卫生质量管理,2025,32(02):83-87.[doi:10.13912/j.cnki.chqm.2025.32.2.19]
　XU Yuanyuan,WU Tao,CHEN Jianyu.Investigation and Analysis of the Status Quo of Peritoneal Dialysis Technology in Shanghai Outer Suburban Community Health Centers[J].Chinese Health Quality Management,2025,32(02):83-87.[doi:10.13912/j.cnki.chqm.2025.32.2.19]

点击复制

上海市远郊社区卫生服务中心腹膜透析技术开展现状调查与分析

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 32 期数: 2025年02期页码: 83-87 栏目: 基层卫生质量出版日期: 2025-02-15

Title:: Investigation and Analysis of the Status Quo of Peritoneal Dialysis Technology in Shanghai Outer Suburban Community Health Centers

作者:: 许媛媛吴韬陈建俞罗莉沈波; 上海市医事团体联合管理发展中心

Author(s):: XU Yuanyuan; WU Tao; CHEN Jianyu; Shanghai Medical Group Joint Management Development Center

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

Keywords:: Peritoneal Dialysis; Community Health Centers; Appropriate Technology; Outer Suburban Areas; End-Stage Renal Disease; Hierarchical Diagnosis and Treatment

分类号:: R197.1

DOI:: 10.13912/j.cnki.chqm.2025.32.2.19

文献标志码:: A

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。

Abstract:: ObjectiveTo 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.MethodsFrom March to May 2024, a questionnaire survey and semi-structured interview were conducted among key informants in A, B and C district.ResultsDistrict 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.

参考文献/References:

［1］WANG LM,XU X,ZHANG M,et al.Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance［J］.JAMA Intern Med,2023,183(4):298-310.［2］WARK DM.Hypnosis and end-stage renal disease: review and treatment［J］.Am J Clin Hypn,2020,63(1):36-48.［3］GARCIA-GARCIA G,JHA V,World Kidney Day Steering Committee.Chronic kidney disease in disadvantaged populations［J］.Braz J Med Biol Res,2015,48(5):377-381.［4］FEDER J,NADEL MV,KRISHNAN M.A matter of choice:opportunities and obstacles facing people with ESRD［J］.Clin J Am Soc Nephrol,2016,11(3):536-538.［5］MA TT,YANG ZK,LI SM,et al.The Peritoneal Dialysis Telemedicine-assisted Platform Cohort (PDTAP) study: design and methods［J］.Perit Dial Int,2022,42(1): 75-82.［6］BRIGGS V,DAVIES S,WILKIE M.International variations in peritoneal dialysis utilization and implications for practice［J］.Am J Kidney Dis,2019,74(1):101-110.［7］ZHAO XJ,NIU QY,GAN LY,et al.Baseline data report of the China Dialysis Outcomes and Practice Patterns Study (DOPPS)［J］.Sci Rep,2021,11(1):873.［8］BELLO AK,OKPECHI IG,OSMAN MA,et al.Epidemiology of peritoneal dialysis outcomes［J］.Nat Rev Nephrol,2022,18(12):779-793.［9］VACCARO CM,SOPRANZI F.A comparison between the costs of dialysis treatments in Marche Region, Italy:Macerata and Tolentino hospitals［J］.Ann Ist Super Sanita,2017,53(4): 344-349.［10］中国医师协会肾脏内科医师分会，国家肾脏质控中心.我国首个《自动化腹膜透析中国专家共识》发布,助力血液净化大国向血液净化强国迈进［J］.上海医药,2020,41(23): 81.［11］GUO WQ,LIU GJ,MA L,et al.The impact of healthcare reform on the dynamic changes in health service utilization and equity:a 10-year follow-up study［J］.Sci Rep, 2022,12(1):3576.［12］叶蕊,钱爱兵,林鹏.基于空间杜宾模型的我国基层卫生技术人力资源配置评价研究［J］.健康发展与政策研究,2024,27(1):74-80.［13］MA XY,TAO M,HU Y, et al.Clinical outcomes,quality of life,and costs evaluation of peritoneal dialysis management models in Shanghai Songjiang District:a multi-center and prospective cohort study［J］.Ren Fail,2021,43(1):754-765.［14］付佳,肖海敏,刘红梅,等.“互联网+护理”背景下居家腹膜透析患者延续护理研究进展［J］.临床医学研究与实践,2024,9(12):179-182. ［15］国家卫生健康委员会.中国卫生健康统计年鉴2022［M］.北京:中国协和医科大学出版社,2022:70.［16］YU XQ, NAKAYAMA M,WU MS,et al.Shared decision-making for a dialysis modality［J］.Kidney Int Rep,2022,7(1):15-27.［17］姚保栋,房良,江云,等.我国医院循证管理与卫生技术评估研究可视化分析［J］.中国卫生质量理,2023,30(4):71-75.［18］孙鑫,谭婧,王雯,等.建立真实世界数据与研究技术规范,促进中国真实世界证据的生产与使用［J］.中国循证医学杂志,2019,19(7):755-762.［19］王雯雯,曹艳佩,顾艳荭,等.上海三级综合医院腹膜透析患者就诊现状及就诊意向调查［J］.上海护理,2023,23(2):34-38.

相似文献/References:

[1]杨山石何梅汤洁金春林王贤吉.基于DRGs的上海嘉定医疗服务质量与绩效评价研究[J].中国卫生质量管理,2017,24(03):22.[doi:10.13912/j.cnki.chqm.2017.24.3.08]
[2]薛梓晨秘玉清陈倩邢家润黄静雯寇儒欣邓神根李伟.山东省社区卫生服务中心老年慢病管理脆弱性评价研究[J].中国卫生质量管理,2023,30(08):75.[doi:10.13912/j.cnki.chqm.2023.30.8.16 ]
　XUE Zichen,MI Yuqing,CHEN Qian.Vulnerability Evaluation of Elderly Chronic Disease Management in Community Health Service Centers of Shandong Province[J].Chinese Health Quality Management,2023,30(02):75.[doi:10.13912/j.cnki.chqm.2023.30.8.16 ]
[3]朱思宇白雪蔡正坤陶军毛靖.基于SERVQUAL模型与IPA分析的武汉市社区卫生服务中心服务质量评价[J].中国卫生质量管理,2023,30(10):62.[doi:10.13912/j.cnki.chqm.2023.30.10.14 ]
　ZHU Siyu,BAI Xue,CAI Zhengkun.Service Quality Evaluation of Wuhan Community Health Service Center Based on SERVQUAL Model and IPA Analysis[J].Chinese Health Quality Management,2023,30(02):62.[doi:10.13912/j.cnki.chqm.2023.30.10.14 ]
[4]宋景晨李远萌潘琦吴锁薇盖媛媛姚德明.基于医联体的“专科—全科团队”模式效果评估[J].中国卫生质量管理,2023,30(12):44.[doi:10.13912/j.cnki.chqm.2023.30.12.10 ]
　SONG Jingchen,LI Yuanmeng,PAN Qi.Evaluation of the Effect of "Specialty-General Practice Team" Mode Based on Medical Association[J].Chinese Health Quality Management,2023,30(02):44.[doi:10.13912/j.cnki.chqm.2023.30.12.10 ]
[5]胡岳秀王清郑雅宁夏冬云陈雁吴春英.江苏省148家社区卫生服务中心护理质量管理现状调查与分析[J].中国卫生质量管理,2024,31(05):41.[doi:10.13912/j.cnki.chqm.2024.31.5.10]
　HU Yuexiu,WANG Qing,ZHENG Yaning.Investigation and Analysis of Status Quo of Nursing Quality Management in 148 Community Health Service Centers in Jiangsu Province[J].Chinese Health Quality Management,2024,31(02):41.[doi:10.13912/j.cnki.chqm.2024.31.5.10]
[6]林婷婷吴彬叶文成崔晓田蔚然.基于名中医工作室的医院-社区结合脑卒中康复模式构建研究[J].中国卫生质量管理,2025,32(07):87.[doi:10.13912/j.cnki.chqm.2025.32.7.19]
　LIN Tingting,WU Bin,YE Wencheng.Research on the Construction of a Hospital-Community Integrated Stroke Rehabilitation Model Based on the Famous Traditional Chinese Medicine Physician Studio[J].Chinese Health Quality Management,2025,32(02):87.[doi:10.13912/j.cnki.chqm.2025.32.7.19]
[7]周芬潘菊美王晓琳何梦雪米蔷曹庆张峻玮杨科佳沈南平.上海市儿童安宁疗护协同转介服务模式构建[J].中国卫生质量管理,2025,32(08):54.[doi:10.13912/j.cnki.chqm.2025.32.8.12]
　ZHOU Fen,PAN Jumei,WANG Xiaolin.Construction of a Collaborative Referral Service Model for Pediatric Palliative Care in Shanghai[J].Chinese Health Quality Management,2025,32(02):54.[doi:10.13912/j.cnki.chqm.2025.32.8.12]
[8]焦岳龙王娟娟马鸣骁金逸耿益民王瑱张煜婷余飞.分级诊疗背景下上海市三级医院家庭医生签约居民预约转诊服务模式实践[J].中国卫生质量管理,2025,32(11):80.[doi:10.13912/j.cnki.chqm.2025.32.11.16]
　JIAO Yuelong,WANG Juanjuan,MA Mingxiao.Practice of Referral Service Models for Family Doctor-Contracted Residents in Tertiary Hospitals of Shanghai under the Background of Hierarchical Medical System[J].Chinese Health Quality Management,2025,32(02):80.[doi:10.13912/j.cnki.chqm.2025.32.11.16]
[9]陈云峰顾珊珊张春燕李甜甜姜政男潘雅萍.分级诊疗背景下社区卫生服务中心预约转诊患者失约影响因素分析[J].中国卫生质量管理,2025,32(11):84.[doi:10.13912/j.cnki.chqm.2025.32.11.17]
　CHEN Yunfeng,GU Shanshan,ZHANG Chunyan.Analysis of Influencing Factors on Non-Attendance among Patients with Referral Appointment at Community Health Service Centers under the Background of Hierarchical Medical System[J].Chinese Health Quality Management,2025,32(02):84.[doi:10.13912/j.cnki.chqm.2025.32.11.17]
[10]陈云峰盖玉婷顾珊珊王效国潘雅萍秦晟博.社区卫生服务中心夜间门诊急性疾病服务需求及影响因素分析[J].中国卫生质量管理,2026,33(2):87.[doi:10.13912/j.cnki.chqm.2026.33.2.18]
　CHEN Yunfeng,GAI Yuting,GU Shanshan.Analysis of Service Demand and Influencing Factors for Acute Diseases in Night Clinics of Community Health Service Centers[J].Chinese Health Quality Management,2026,33(02):87.[doi:10.13912/j.cnki.chqm.2026.33.2.18]

更新日期/Last Update: 2025-02-15