| Research BackgroundRehabilitation is under the guidance of the theory of modern rehabilitation medicine, combining the advantages of traditional medicine of the motherland, the application of rehabilitation assessment and physical therapy, occupational therapy, traditional rehabilitation therapy, speech therapy, psychotherapy, diagnostic and therapeutic technologies rehabilitation works of rehabilitation medicine, and in close collaboration with clinical departments, focusing on the acute phase of disease, injury, subacute phase and recovery phase of the relevant body, internal organs, in patients with advanced brain function and mental dysfunction and disability in patients with severe, complex and difficult to provide a comprehensive and systematic rehabilitation medical clinic services, and as a regional resource center provides rehabilitation medicine where the community health service network rehabilitation medicine technology consulting, training, rehabilitation and technical guidance for the area function disabled patients department. Rehabilitation is one of 12 medical subjects a former State Department of Health determined the necessary clinical departments also large general hospital, the hospital is the embodiment of comprehensive strength.With the development of society, advances in medical science and technology, the level of protection of people’s health improved, people today evaluation of medical services no longer limited to the standard first-aid and treatment, understanding health no longer stay in the absence of disease, but requires in terms of physical, psychological and social are in good condition, that needs to have overall physical and mental health model of care. In addition, as the disease changes in the structure, due to chronic dysfunction and disability greatly increased, clinical medicine has been difficult to adapt to these changes. This requires changing the original medical workers’ treatment-help "two-dimensional medical model is not only life-saving medical treatment, but also to emphasize the functional recovery, is the real meaning of health. Therefore, the modern medical model to the bio from the biomedical model-transition Sociological mode [1]-psychology. Back in the late 1970s, WHO pointed out that modern medicine is prevention, complete system four aspects of health, clinical and rehabilitation constituted. Rehabilitation medicine is a new concept in the mid-20th century, and is an emerging discipline, medicine is a new branch is the result of modern scientific and technological progress. It is the body’s dysfunction caused by disease after the study of disability, rehabilitation assessment, rehabilitation training, rehabilitation, improvement or reconstruction of a patient in order to achieve physical, mental, social function for the purpose of a science, including disability rehabilitation, clinical rehabilitation therapy, basic rehabilitation, clinical rehabilitation evaluation and other disciplines.Research purposesThis through the literature review to carry out the construction of the army general hospital rehabilitation medicine theory, through the field investigation in the army a certain level of first-class comprehensive hospital rehabilitation medicine development present situation research, and on this basis, it puts forward the model of rehabilitation medicine service, at the same time set up evaluation index system of the army general hospital rehabilitation medicine construction, for the army general hospital rehabilitation medicine construction to provide decision-making reference.Research methods1. Literature ReviewNow the national systems, military construction-related documents on Rehabilitation regulations, rules and regulations, and related documents, to understand the basic concepts of the basic theory of the construction of Rehabilitation Medicine, carding army General Hospital Department of Rehabilitation.2. Expert adviceSelect a representative military hospital management experts, the Army General Hospital Department of Rehabilitation evaluation index system, index weight for consultation, seek expert advice.3. Scene InvestigationGuangzhou Military Region visited by three general hospitals, collecting and Rehabilitation Construction-related first-hand material, to provide support for future study.4. QuestionnaireHomemade "Army General Hospital Department of Rehabilitation Evaluation Index System expert advice table" and "Army General Hospital Department of Rehabilitation Evaluation Index System of expert advice at all levels of index table" with experts Index System survey.5. The panel discussionChoice of hospital management experts, hospital Rehabilitation department director, doctors and other relevant departments of different personnel, team composition, construction-related issues for the Army General Hospital Department of Rehabilitation regular meetings to study the formation of opinion.6. the DelphiIs prepared by the investigator questionnaires, correspondence manner to the members of the Group were consulted. After much consultation and feedback, higher accuracy collective judgment result. The later studies using this method the Army General Hospital Department of Rehabilitation Evaluation Index System to build.7. Analytic HierarchyAHP is a common multi-level weight analysis method, this study determined using AHP Army General Hospital Department of Rehabilitation Evaluation System weight coefficient.Research result1. Investigate the army general hospital hospital rehabilitation medicine technician has increased every year since 2011, has a technician 21, including rehabilitation physician 13, full-time rehabilitation technician 8, talent development gradually, but according to the request of industry standard rehabilitation physicians lack 2, especially high title and a shortage of highly educated personnel. Although full-time rehabilitation technician number is limited, but internship training of health personnel, basic can meet the needs of the daily work.2. The hospital rehabilitation medicine in 2014 compared with 2011 outpatient visits increased from 6814 to 6814 person-time,17.6% increase, outpatient visits for patients, on average, increased from 16.8 days to 27.34 days of such confinement. Hospitalized from 809 in 2011 to 2014 in 2014, the growth of 27.1%, in each of the hospital economic income growth above 35%, showed that patients with growing demand for rehabilitation medicine services, the survey results with the survey focus on disease to 2011-2014 average increase year by year of such confinement or continue to coincide with the trend of the high, such as lumbar disc (12.58 days to 12.58 days), brain trauma sequela (19 days to 34.33 days), cervical spondylosis (11.28 days to 11.28 days), traumatic severe brain injury (70 days to 81.39 days).3. The survey also showed that as indicators of hospital core control key, orthopaedic trauma from 2011 to 2014 the average compression by 15.31 days to 13.16 days of such confinement, spinal bone disease section average compression by 18.66 days to 16.50 days of such confinement, cerebral surgery average such confinement compression from 20.36 days to 20.36 days, all hospitals bed and bed turnover data continue to improve. And at the same time, the backbone to rehabilitation medicine department to make a diagnosis and give treatment increased year by year, the number of such as orthopaedic trauma from 2011 to 2014 referrals increased from 63 to 63 person-time, spinal bone disease referral by 43 increased to 130, neurology referral from 58 to 76, cerebral surgery referral from 56 to 164, in order to optimize the hospital internal medical practice, the department of rehabilitation medicine requirements are also gradually to increase.4. In this study refer to general hospital rehabilitation medicine discipline construction work related policies, document and review the related literature, on the basis of combining with the present situation in the construction of the army general hospital rehabilitation medicine, rehabilitation medicine service model was proposed, and the indicators related to the construction of the army general hospital rehabilitation medicine collected, expert discussion, Delphi expert consultation method is used to discuss the indicators, demonstration, and selection, combined with the expert opinion and the suggestion, modify indicators, build the evaluation index system of the army general hospital rehabilitation medicine construction frame, and after two rounds of expert consultation, eventually become the basic conditions, medical technical team, medical, teaching, scientific research level, the five indicators of serving the army; Development environment, such as junior size 14 secondary indicators; The specialized subject construction and development planning, support policies and measures such as 46 measures of level 3, for the army general hospital rehabilitation medicine construction to provide decision-making reference.Analysis conclusionIn this paper, through literature review and survey analysis, this paper discusses the developing situation of the army general hospital rehabilitation medicine and demand situation, this paper puts forward the construction of the army general hospital rehabilitation medicine mode, discusses the construction of the basic requirements, the construction strategy and discipline model, put forward to establish general hospital rehabilitation disciplines, form a cross between rounds, consultation mechanism, help and the concrete measures of grassroots, reasonable two-way referral. The study also USES the Delphi expert consultation method of the construction of the army general hospital rehabilitation medicine is established evaluation index system, puts forward the six indicators,16 secondary index,57 three-level index, and USES the analytic hierarchy process (ahp) to set the weights, the army general hospital rehabilitation medicine construction model is established.Due to the limitation of time and energy, in the construction of the army general hospital rehabilitation medicine mode research there are still some problems remain to be solved, mainly as follows:1. The rehabilitation medicine, on average, how to establish the medical indicators such as the problem of such confinement; 2. How to standardize the rehabilitation medicine in terms of policy system classification referral management; 3. With recovery function rehabilitation hospital and pension institution construction and regional configuration needs to be further strengthen, with comprehensive hospital complement each other. Countermeasures and Suggestions put forward by the institute are crude Jane, and need further practice verification, to optimize the above countermeasure and improve the pertinence and effectiveness. |
PDF Full Text Request