| Objective:Based on the severe situation of respiratory disease prevention and control in china,respiratory discipline needs to be developed urgently to meet the bigger challenges,this paper analyzes the present situation of department construction of respiratory and critical medical department(hereinafter referred to as "PCCM department")in secondary and tertiary medical institutions,the effectiveness of standardized construction and the problems combination with the actual situation.MethodsThis research relies on the PCCM department standardization construction project,uses the literature research method to the domestic and foreign construction related research present situation,summarizes the related theory foundation;carries on the investigation to the second and third level medical institution PCCM department standardization construction,uses the statistical method to carry on the analysis to each medical institution,the department medical treatment,the teaching,the research,the management,the talented person training situation and carries on the standardization construction work effect;uses the word cloud tool to carry on the visual analysis to further development standardization construction faces the question text data.ResultThe present situation of standardized construction of PCCM departments and departments in ? and ? medical institutions:With regard to medical equipment and technology,the average number of common beds in PCCM departments of level ? and ?medical institutions was(62.22 ± 39.20)and(92.87±48.92),respectively.The average number of MICU/RICU beds was(5.45±3.55)and(11.40±6.46)respectively.There are still 47.83%of tertiary hospitals PCCM departments are not equipped with ECMO,only 14.97%of secondary hospitals are equipped with exercise lung function instrument,73.80%of secondary hospitals have 2 sets of respiratory endoscopy sets,and most secondary and tertiary hospitals can carry out routine medical projects that match their service functions,and some of the more difficult techniques and critical treatment techniques have not been carried out.Department of human resources and workload,the second and third level hospital lung function room and respiratory endoscopy room are mostly equipped with 4 or more full-time personnel.There are 16.58%and 45.26%annual discharge in PCCM departments of level ?and ? medical institutions,respectively,more than 3000,10.47%annual outpatient visits in PCCM departments of level ? hospitals are more than 100,000,5.88%annual outpatient visits in PCCM departments of level ? hospitals are more than 60,000,the number of annual lung function examinations in level ? hospitals is mostly between 6000?9999,and the number of annual lung function examinations in level ? hospitals is mostly between 2000 and 4000.In terms of department management,44.92%and 53.36%of the primary pulmonary function examinations of COPD in secondary and tertiary medical institutions were more than 95%and tertiary medical institutions carried out clinical pathway and single disease management,and the number of hospitals with follow-up rates of patients with chronic airway diseases greater than 95%in tertiary hospitals was higher than that in secondary hospitals.In teaching and research,40.12%of the PCCM departments of tertiary medical institutions may enroll master's degree students,26.28%doctoral students,29.84%of the PCCM departments of tertiary medical institutions have no scientific research projects at the provincial/bureau level or above in the last three years,48.81%have no national scientific research projects in the last three years,72.19%have no scientific research projects in the last three years of secondary medical institutions,and 51.87%have no Chinese core journal papers in the last three years.In terms of personnel training,44.47%of doctors with master's degree in PCCM subjects in tertiary medical institutions accounted for more than 50 per cent,68.18%for doctors with doctor's degree less than 20 per cent,and 69.52%for doctors with graduate degree in secondary medical institutions less than 30 per cent.Effectiveness of standardized construction:In terms of capital investment,1.809 billion yuan has been invested by medical institutions at all levels in the standardized construction of PCCM departments,of which 1.162 billion yuan has been invested by level ? and ? medical institutions and 647 million yuan by the government.According to the investment projects,about 1.186 billion yuan has been invested in the purchase of medical equipment,and 623 million personnel training,scientific research projects,ward construction,medical site construction and other projects.In terms of human resour ces,1667 new doctors,3,464 nurses and 452 technicians have been added to PCCM standardized construction in the surveyed medical institutions.More human resources were invested in tertiary medical institutions than in secondary medical institutions.In terms of medical treatment and technology,a total of 8500 new beds in general wards of PCCM departments and 1183 new beds in rescue rooms of 364 medical institutions have been added in 640 medical institutions,PCCM departments of tertiary hospitals have reached the national recommended standard in hardware facilities after construction,77.78 per cent have reached the basic standard in the construction of sleep breathing diagnosis and treatment after construction,39.73 per cent have reached the national basic standard in key medical technologies after construction and 20.83%of the hardware equipment reached the national recommended standard after construction,20%of the lung function construction reached the recommended standard after construction,48.28%of the sleep breathing diagnosis and treatment construction reached the recommended standard after construction,and 68.18%of the key medical technology reached the basic standard after construction.Difficulties in further standardization construction:The main difficulties in the standardization construction of PCCM departments tertiary medical institutions mainly lie in the lack of scientific research projects,the difficulty in building the talent team,the inability of staffing to meet the needs of the development of departments and the insufficient attention of leaders;the difficulties in the standardization construction of PCCM departments of secondary medical institutions mainly lie in the shortage of human resources,lack of standardized training,low level of chronic disease management and insufficient attention of leaders.ConclusionAt present,the standardized construction of PCCM departments in level two and three hospitals has prompted governments and hospitals at all levels to increase their investment in respiratory discipline,which will help to improve the ability of prevention,diagnosis and treatment of respiratory diseases in medical institutions at all levels and the level of personnel construction,and help the development of disciplines.However,hospitals at all levels still have the problems of insufficient attention to PCCM departments,non-homogeneous technical level,lack of scientific research ability and insufficient strength of talent team building in the construction of standardization.Local government departments are advised to strengthen support to PCCM departments of secondary and tertiary medical institutions,strengthen publicity and raise social awareness of PCCM departments and related policies;hospitals themselves should increase investment in scientific research and personnel training;the industry should continue to promote PCCM standardized construction projects,regular review,dynamic adjustment of construction standards,and ultimately promote the development of homogenization of PCCM departments. |
PDF Full Text Request