摘要
目的
本研究旨在对中医医疗服务和中医医疗质量作出界定,分析中医服务的内涵和特点,归纳中医医疗服务质量影响因素,指明建立中医医疗服务质量评价体系的必要性,最终确立中医服务质量评价的维度,为客观评价中医医疗服务质量提供理论基础,提出中医医疗机构提高服务质量的建议和对策,从而有力地推动我国中医药事业的全面、快速地发展。
方法
1.文献研究法
通过Medline、CNKI光盘等检索软件、Internet网络等途径,查阅国内外有关专著和学术论文等文献资料本课题所需要的相关文献。
2.深入访谈法
通过对中医医疗机构、中医学研究机构的管理人员、临床医师、中医专家的深入访谈,了解中医医疗的特点和优势,认识中医医疗发展现状及其影响因素,咨询评价中医医疗服务的方法及对策。
3.规范分析法
综合运用中医理论基础、中医诊断学、卫生政策、管理学等相关知识和理论,进行综合分析与逻辑推理。
结果
1.中医医疗服务是一种具有中医特色的医疗服务,是指以中医医疗机构为主体,中医技术人员以整体观念和辨证论治为指导思想,通过望、闻、问、切四诊法和辅助仪器,综合运用阴阳五行、脏腑经络、病因病机、四诊八纲、辨证施治等理论指导临床诊断和治疗,并以中药方剂为主要治疗手段,以针灸、推拿、拔火罐、药膳、气功、冬病夏治等为独特的治疗方法,合理利用一定的卫生资源,向人民群众提供卫生服务的过程,是一种具有科学性、实用性和时代性的医疗服务。狭义上是指临床医疗服务,广义上包括预防、医疗、保健、康复、健康教育服务等内容。
2.中医医疗服务特色:中医特色就是以唯物辩证为指导思想,以整体观念为理论基础,以辨证论治为基本核心,以方剂药物为基本手段,突出自身优势,扩大自身的影响力。
3.中医医疗服务质量:随着我国医学模式向“生物-社会-心理-环境”医学模式的转变,本研究在三级医疗服务质量理论的基础上,将中医医疗服务质量内涵分为专业技术质量、功能质量、管理质量和患者相关质量。
4.中医医疗评价现状:中医和西医是医学科学中的两个不同性质的学科,西医医疗服务质量评价方法不完全适应中医医疗服务质量的评价,而现有中医医疗质量评价研究基本都围绕中医临床疗效展开,属于狭义上的医疗质量评价,且其评价方法不能反映中医特色和优势,造成中医发展严重滞后于现代医学。因此,建立符合中医医疗服务自身特点的服务质量评价体系有着重要紧迫性和必要性。
5.中医医疗服务影响因素:研究发现中医服务发展受国家规划政策、经济投入、中医教育事业的影响很大,同时中医自身特点也是造成中医发展滞后的主要原因。
结论
1.中医医疗服务是一种具有中医特色的医疗服务,有自身独特的理论基础和临床医疗技术,需要与现代医学相区别,中医特色主要体现在医疗指导思想、诊断特点、治疗特点及服务范畴。
2.中医医疗服务质量的改善和提高时一个系统过程,需要政府、中医医疗机构、中医教育体系共同协调合作,促进中医药事业的整体飞跃。
3.构建中医医疗服务质量评价模型能够突出中医医疗特色和优势,有利于对中医服务做出客观的评价,为中医医疗机构管理者和国家中医药事业发展政策制定者提供参考。
Objective
The purpose of this study is defining Chinese medical services and Chinese medical quality. By the analysis the content and Characteristic of Chinese medical services, we can find out the factors of Chinese medical quality, then indicate the necessity of establishment of Chinese medical services quality evaluation system, eventually establish the dimension of quality evaluation of Chinese medicine services, provide a theoretical basis for evaluating of the quality of Chinese medicine services objectively, and make proposals and countermeasures to improve the quality of Chinese medical institutions services, thus advance our traditional Chinese medicine a comprehensive and rapid development effectively.
Methods
1. Literature research
Through Medline, CBM, CNKI, Internet to search the monographs and academic papers and other documents of domestic and international about this study.
2. In-depth interviews Through In-depth interviews with Chinese medical institutions, managers of medical research institutions, doctors and Chinese medicine experts, comprehend the features and benefits of Chinese medicine, acquaint the development of Chinese medicine and its influence factors, consulting evaluation methods and strategies for Chinese medicine health care services.
3. Normative analysis
The study composites some related Knowledge and theory in Theoretical basis of Traditional Chinese Medicine, Chinese Diagnostics, Health Policy, Management and so on. Then make comprehensive analysis and logical reasoning.
Result
1. Chinese medical services has their own characteristics, it refers to the Chinese medical institutions as the main, Chinese technical personnel make the overall concept and Differential Treatment as guiding principle of treating. By looking, smelling, questioning and four diagnostic methods and auxiliary equipment, comprehensively use yin yang, five elements, Organs and Meridians, Pathogenesis, Four diagnostic eight principles, Syndrome differentiation and so on, to guide clinical diagnosis and treatment. And Chinese proprietary is the main treatment, Acupuncture, massage, cupping, herbs, and qigong are the unique treatment. Make rational use of health resources; provide health services to the people. It is a kind of specificity, and the era of advanced medical services. Narrow sense, refers to the clinical services, Broad sense, including prevention, health care, health care, rehabilitation, health education services content etc.
2. Chinese medical characteristics: It based on the guiding ideology of dialectical materialism and overall concept, syndrome differentiation as the basic core, prescription drugs as the basic means to highlight its advantages and expand their influence.
3.Chinese medical services quality:With our medical model to "biological - social - psychological - environment" Medical Model,In this study, it based on the theory of quality of medical services at three levels, and divides content of Chinese medical services quality into professional and technical quality, functional quality, management quality and patient-related quality.
4.Status of Chinese medical evaluation:Chinese and Western medical science in the two different kinds of disciplines,Western medical services quality evaluation method does not fully meet the evaluation of the quality of Chinese medical services,but, the existing quality evaluation of TCM basically started around clinical medicine, belongs in the narrow sense of medical quality assessment, and its evaluation does not reflect the Chinese characteristics and advantages, causing serious lag in the development of modern Chinese medicine. Thus, the establishment of Chinese medical services consistent with its own characteristics of service quality evaluation system has an important necessity and urgency.
5. Chinese health care factors: Through the study found the development of Chinese medicine services by national planning policy, Chinese medical management, cultural environment, evaluation criteria and Chinese education are the impact of large. Chinese medicine is also caused by its own characteristics of the main reasons for slow development of the pharmaceutical industry.
Conclusion
1. Traditional Chinese medicine health care is a kind of unique medical services, has its own unique theoretical foundation and clinical medical technology, need to distinguish modern medicine. Chinese medicine characteristics are mainly reflected in the medical guidelines, diagnostic characteristics, treatment characteristics and service areas.
2. Chinese health care quality improvement and enhancement is a system, it need government, the Chinese medical institutions, the Chinese education system, coordination and cooperation together, and make the promotion of traditional Chinese medicine as a whole leap.
3. Construction of Chinese health care quality evaluation model can highlight the features and advantages of Chinese medicine, to help make an objective assessment of Chinese medicine services, and to provide reference for Chinese medical institutions manager and development of countries in the pharmaceutical industry policy makers.
引文
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