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[北京郊区及城区二级医院神经科医疗资源调查]

[A survey of neurological medical care resources in grade II suburban and urban hospitals in Beijing].

作者信息

Wang Yi-long, Wang Yong-jun, Zhao Xing-quan, Liao Xiao-ling, Wu Di, Yang Ya-qin, Hu Chang-mei, Chen Qi-dong, Yang Qing

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2007 Apr;46(4):302-5.

Abstract

OBJECTIVE

To survey the current availability of expertise in diagnosis and treatment of neurological diseases in grade II hospitals (primary hospitals) in Beijing.

METHODS

Observation, personal in-depth interview and structured questionnaire methods were conducted to survey the status of neurology health care system.

RESULTS

From June to August 2005, 66 grade II suburban and urban hospitals in Beijing of China were investigated. There were 66 grade II hospitals in Beijing (suburban 34; urban 32). Cerebrovascular disease was the most common disease. Accounting for 84% of the hospitalized cases in inpatients neurology departments. In urban areas, the proportion of grade II and grade III hospitals (referral hospitals) was 58:60, but in suburban and rural areas, the proportion was 48:6. In suburban and rural areas. Only 64.7% of the hospitals could provide urokinase treatment, 26.5% could provide recombinant tissue plasminogen activator (rt-PA) treatment and 58.8% had standardized operation protocol.

CONCLUSIONS

The grade II hospitals in suburban areas have heavy grave responsibility to deal with cerebrovascular disease, but these hospitals are in lack of specialists, diagnostic equipment and stroke treatment protocols and could not satisfy the medical demand. It is suggested that in the grade II hospitals in suburban areas of Beijing, strengthening personnel training, establishing primary stroke center and setting up telestroke emergency care systems are urgently needed.

摘要

目的

调查北京市二级医院(基层医院)神经疾病诊断与治疗方面的专业人才现状。

方法

采用观察法、个人深入访谈法和结构化问卷调查法对神经科医疗体系状况进行调查。

结果

2005年6月至8月,对中国北京的66家二级城乡医院进行了调查。北京有66家二级医院(郊区34家;城区32家)。脑血管疾病是最常见的疾病,占神经内科住院病例的84%。在城区,二级医院与三级医院(转诊医院)的比例为58:60,但在郊区和农村地区,这一比例为48:6。在郊区和农村地区,只有64.7%的医院能够提供尿激酶治疗,26.5%的医院能够提供重组组织型纤溶酶原激活剂(rt-PA)治疗,58.8%的医院有标准化的操作流程。

结论

郊区二级医院在应对脑血管疾病方面责任重大,但这些医院缺乏专业人才、诊断设备和中风治疗方案,无法满足医疗需求。建议在北京郊区的二级医院,迫切需要加强人员培训、建立初级中风中心并建立远程中风急救系统。

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