Background Rural doctors are the most convenient providers of community-based rehabilitative services for chronic disease patients and disabled people in rural areas, with the promotion of graded diagnosis and treatment policies, people began to pay attention to the competence of community-based rehabilitative services among rural doctors.
Objective By investigating the competence of community-based rehabilitative service among rural doctors, analyzing the shortage of competence, and providing references for improving it.
Methods A multi-stage stratified cluster sampling and purposive sampling methods were used to select 3 916 rural doctors from five provinces in east, central, and western China. The survey was conducted from July to August 2020. The questionnaire mainly focused on investigating the possession of rural doctors' competence in rehabilitation function assessment and community rehabilitation guidance, as well as whether the competence could meet their actual work needs.
Results Of the 3 916 rural doctors surveyed, 2 391 (61.1%), 3 704 (94.6%), 2 365 (60.4%) were found to have competence in rehabilitation function assessment, community rehabilitation guidance, and comprehensive community-based rehabilitative service, respectively. The comparison of the rehabilitation function assessing competence, community rehabilitation guiding competence, and comprehensive community rehabilitation service competence of rural doctors in the eastern, central, and western regions showed statistically significant differences (P<0.001), while the rural doctors in the western region had the lowest proportion of competence; There were statistically significant differences (P<0.05) in the proportion of the rehabilitation function assessing competence and the comprehensive competence of community rehabilitation services among rural doctors with different educational backgrounds and practicing qualifications. Rural doctors with an educational background of technical secondary school/ high school or below had a relatively higher proportion of competence, and general practitioners also had a relatively higher proportion of competence. The proportion of rural doctors who need to provide six services in daily work, including muscle strength grading assessment, motor function assessment, joint activity assessment, rehabilitation guidance for common disease patients, rehabilitation guidance for chronic disease patients, and rehabilitation guidance for disabled patients, was 73.5% (2 880/3 916), 73.8% (2 891/3 916), 74.1% (2 900/3 916), 96.3% (3 773/3 916), 95.9% (3 754/3 916), 89.1% (3 490/3 916), respectively. The proportion of the three classification competencies included in the rehabilitation function assessment competence that meet the work needs does not exceed 75.0%, and the three classification competencies included in the community rehabilitation guidance competence meet the work needs with a rate of 92.4% (3 487/3 916), 91.7% (3 441/3 916), 85.6% (2 987/3 916), respectively.
Conclusion Overall, the community-based rehabilitation service competence of rural doctors in China is in relatively good condition. However, there are deficiencies in the competence of rural doctors in western China. The community-based rehabilitation service competence of rural doctors could meet the needs of rural residents, and with the gradual formation of the continuous rehabilitation service mode of staying in the hospital during the acute period and returning to the community during the recovery period, rural residents will have a higher demand for the community-based rehabilitation service of rural doctors. Therefore, positive measures should be taken to enhance the rehabilitation service competence of rural doctors, and practical exercises are the more effective measures we have found.
