【作者】 陈晔；

【导师】 孙晓生；

【作者基本信息】 广州中医药大学 ， 社会医学与卫生事业管理， 2009， 硕士

【摘要】 中医专科是祖国传统医学的重要组成部分,具有悠久的历史。县级中医院是中医药事业发展的基层机构。县级中医院中医专科建设的情况对整个中医药事业的发展有着深远的影响。以往的研究大多局限于单纯的理论分析或个案报道,对县级中医院中医专科建设的研究缺乏系统性和全面性。本研究主要采用文献研究法、问卷调查法和统计分析法等综合方法。在查阅近20年相关文献,了解国内外研究现状的基础上,对珠江三角洲地区的广州和肇庆,粤北的韶关,粤西的阳江和粤东的汕头等5个地级市的34家县(区)级中医院和5家市级中医院中医专科的建设现状进行调查。对其中建有中医专科的20家县(区)级中医院,围绕专科医疗情况、人员、科研、院内中药制剂、宣传和专科发展的地区差异等内容进行分析,并与5家市级中医院做比较,以了解广东县级中医院中医专科建设所存在的问题。在数据处理过程中,主要采用了t检验、非参数检验、相关分析、回归分析等方法。本研究结论指出广东县级中医院中医专科建设存在以下问题:(1)专科发展规划有待优化。专科建设比例不高,专科选择欠合理,发展水平参差不齐。(2)学科队伍建设有待完善。专科人才缺乏情况较严重,未建成高级、中级、初级职称人员相结合的人才梯队,学科带头人扮演着医疗专家与管理人员的双重角色,学术继承人的设置未得到足够的重视。(3)科研能力有待加强。专科人员未能认识到开展科研的重要性,只是置身于日常医疗事务,且目前专业技术队伍的训练主要集中在医疗方面,缺乏对研究能力的系统培养。(4)院内中药制剂面临发展瓶颈。当前中药院内制剂的管理主要是参照新药审批标准,不能反映中医药的规律和特点,很多医院放弃了院内制剂的申报开发。(5)宣传意识有待增强。宣传质量不够,时效性不足,宣传方法单一。(6)专科建设存在地区差异。珠江三角洲地区中医专科建设明显优于粤北地区。本研究提出促进广东县级中医院中医专科建设的建议如下:(1)加强中医专科建设的规划和管理。(2)完善专科人才队伍建设。(3)提升专科科研水平。(4)优化专科院内中药制剂的发展。(5)重视专科宣传工作。(6)重视经济欠发达地区中医专科建设。并提出今后县级中医院中医专科的发展可围绕大力发展健康产业,优化单病种管理和强化专科在社区卫生服务的功能等三大方面。县级中医院中医专科建设是广东省发展中医药事业的重要构成。在医疗市场竞争日趋激烈的今天,唯有突出特色才是取胜之道。县级中医院走精而专的道路,中医药事业才能得到更好的发展。更多还原

【Abstract】 The speciality of traditional Chinese medicine(TCM), which has a long history in China, is an important component of TCM. County-level hospitals of TCM are grassroot institutions of TCM, and the building of speciality of TCM in county-level hospital of TCM has a profound impact on the whole development of TCM. In the past, investigations were mostly limited to the theoretical analyses or case reports, which lacked of systematic and comprehensive analysis.This study used literature research, questionnaire survey and statistical analysis. By searching the relevant literatures over the past 20 years to know the status of basic research, this research studied the situation of the building of 34 county-level and 5 city-level hospitals of TCM in Guangzhou, Zhaoqing, Shaoguan, Yangjiang and Shantou City, and studied 20 county-level hospitals of TCM that have speciality of TCM, focusing on medical condition, personnel, scientific research, preparations produced in hospital, regional differences, and making comparison with that of 5 city-level to understand the existing problems of the building of speciality of TCM in county-level hospitals in Guangdong province. In data processing, this study used t test, nonparametric test, correlation analysis and regression analysis.This study concludes that problems existing in the building of speciality of TCM in county-level hospitals of TCM in Guangdong are as follows:(1)Plan of speciality development needs to be optimized. The proportion of speciality built is not high, lacking of a reasonable selection, and the level of development needs to be improved. (2)The building of academic team remains to be improved. Shortage of expert and an uncompleted combination of various titles, academic leader and medical expert is playing a dual role of manager, academic heir in speciality building does not receive enough attention. (3)Scientific research capacity needs to be improved. Speciality staff fails to recognize the importance of scientific research, but the day-to-day medical service, and professional technical teams are currently training mainly concentrated on the area of health care.(4)Chinese medicine preparation produced in hospital is facing development bottlenecks. The management of preparation produced in hospitals is referenced to the criteria of new drug, which could not reflect the rules and characteristics of TCM, so that a lot of hospitals abandoned to declare and develop preparations. (5)Publicity awareness needs to be enhanced. Not enough quality, timeliness insufficient and ways single. (6)Speciality building regional difference exists. The building of speciality of the Pearl River Delta region is better than that of the northern part of Guangdong province.This study puts forward suggestions to promote the building of speciality of county-level hospitals of TCM in Guangdong as follows:(1)Strengthen the planning and management of speciality of TCM. (2)Improve the building of personnel. (3)Enhance the level of scientific research. (4)Optimize the development of preparations produced in hospitals. (5)Pay attention to propaganda work. (6)Focus on the building of speciality of TCM in underdeveloped areas. In the future, the building of speciality of TCM in county-level hospitals could focus on the health industry, optimize the single-disease management and strengthen influence in community health service.The building of speciality of TCM in Guangdong is the priority of the development of TCM. In such an increasingly competitive healthcare market, the only way to develop is to highlight the characteristics, so that TCM would have a brighter future.更多还原