West China School of Medicine, Sichuan University, Chengdu, 610041, Sichuan, PR China.
International medical center/center of general practice, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, PR China.
BMC Health Serv Res. 2020 Jul 8;20(1):625. doi: 10.1186/s12913-020-05480-3.
World Health Organization initiated community-based rehabilitation (CBR) in 1978, and by now, it has been an essential process of medical services worldwide. China had strengthened primary health care on building more than 35,000 community health centers (CHCs) in cities, and more than 34,000 township health centers (THCs) in the rural area. Nevertheless, it remains unclear that if these primary health centers could provide optional rehabilitation services for disabilities. And this study aims at evaluating the supply capacity of rehabilitation service in primary health centers of Chengdu, a regional center city of southwest China.
We conducted a general investigation of primary health centers in Chengdu, a city located in southwest China with more than 15 million population. Our investigation covered all of Chengdu's 390 primary health centers from October to November 2016. We researched these primary health centers on basic rehabilitation services, diseases, and rehabilitation equipment quantity and quality, and traditional Chinese medicine (TCM) physiotherapy.
Rehabilitation therapy is available in 88.9% (337 of 379) of all primary health centers. Meanwhile, CHCs slightly surpass THCs with an available rate of 92.2% (106 of 115) and 87.5% (231 of 264), respectively. Traditional Chinese Medicine (TCM) physiotherapy is available in 97.1% (368 of 379) of all primary health centers, 97.3% (112 of 115) of CHCs and 97.0% (256 of 264) of THCs. Quantitative analysis showed that substantial factors which could make an impact on the number of patients per year contain: categories of rehabilitation disease (P < 0.001, 95% confidence interval (CI) [- 1.571, - 0.702]),number of rehabilitation bed (P < 0.001, 95%CI [- 1.249, - 0.290]).
CBR and TCM physiotherapy has become accessible for disabilities in most basic health centers of Chengdu City, whereas, available rate of CBR in THCs is lesser than in CHCs, which suggests an imbalance in primary health service development between rural and urban area. Categories of rehabilitation diseases, and the number of rehabilitation beds constitute co-factors that make an impact on the CBR capacity of basic health centers.
世界卫生组织于 1978 年启动社区康复（CBR），如今，它已成为全球医疗服务的重要组成部分。中国通过在城市建立 35000 多个社区卫生中心（CHCs）和 34000 多个乡镇卫生院（THCs），加强了基层医疗保健。然而，目前尚不清楚这些基层医疗机构是否能够为残疾人提供可选的康复服务。本研究旨在评估中国西南地区中心城市成都的基层卫生中心的康复服务供给能力。
我们对中国西南部人口超过 1500 万的城市成都的基层卫生中心进行了全面调查。我们的调查涵盖了 2016 年 10 月至 11 月成都的 390 个基层卫生中心。我们研究了这些基层卫生中心的基本康复服务、疾病以及康复设备的数量和质量，以及中医理疗。
88.9%（337/379）的基层卫生中心提供康复治疗。同时，CHCs 的覆盖率略高于 THCs，分别为 92.2%（106/115）和 87.5%（231/264）。97.1%（368/379）的基层卫生中心提供中医理疗，97.3%（112/115）的 CHCs 和 97.0%（256/264）的 THCs 提供中医理疗。定量分析表明，对每年患者人数有显著影响的因素包括：康复疾病类别（P<0.001，95%置信区间（CI）[-1.571，-0.702]），康复床位数量（P<0.001，95%CI[-1.249，-0.290]）。
成都大部分基层卫生中心都可以为残疾人提供 CBR 和中医理疗服务，然而，THCs 的 CBR 覆盖率低于 CHCs，这表明城乡基层卫生服务发展不平衡。康复疾病类别和康复床位数量是影响基层卫生中心 CBR 能力的共同因素。
