湖北省县域医疗卫生机构信息化水平评价指标体系研究

发布时间：2018-03-12 15:34

本文选题：县域医疗卫生机构　切入点：信息化水平评价　出处：《华中科技大学》2013年硕士论文　论文类型：学位论文

【摘要】：基层医疗卫生机构信息化建设是医药卫生体制改革的重要内容之一，是深化医改的重要技术支撑和保障。国务院《“十二五”期间深化医药卫生体制改革规划暨实施方案》（国发〔2012〕11号）明确提出加快推进基层医疗卫生机构信息化，在试点基础上，以省为单位，建立基层医疗卫生信息系统，提高基层医疗卫生服务水平。国家发改委、卫生部联合印发的《基层医疗卫生机构管理信息系统建设项目指导意见》明确提出：到2015年逐步建成覆盖城乡基层医疗卫生机构的信息系统。2010年国家投入18.9亿进行中西部42.3万个村卫生室信息化建设，2011年又投入12.5亿进行31个省的基层医疗卫生机构管理信息系统建设。在国家政策及国家建设资金的支持下，目前基层医疗卫生机构信息化建设正呈现快速发展的态势。为促进湖北省县域医疗卫生机构信息化建设和管理，提高基层医疗卫生机构信息化建设质量和应用水平，研究建立科学合理、客观公正、操作简便的湖北省县域医疗卫生机构信息化水平评价指标体系已成为当前亟待解决的关键问题。 [目的]本研究以国家政策为指导，以前期项目《湖北省医院信息化现状调查》（鄂卫函〔2010〕179号）为基础，结合湖北省县域医疗卫生机构信息化建设现状，借鉴国内外相关研究成果，坚持先进性、可比性、可操作性、导向性等指标构建原则，，探索建立适合湖北省县域医疗卫生机构信息化水平的评价模型、指标体系、评价方法和评价细则，用于湖北省县域医疗卫生机构信息化水平的测评。 [方法]通过文献分析法和现场调研法构建湖北省县域医疗卫生机构信息化水平评价模型和初始指标库；应用专题小组讨论法商榷湖北省县域医疗卫生机构信息化水平评价方法，并修改和完善初始模型和指标库；运用专家会议法和关键绩效指标法筛选优化指标并确定评价方法。 [结果]⑴构建了湖北省县级医院信息化水平评价指标体系和评价细则湖北省县级医院信息化水平评价指标体系主要包括信息化保障体系、信息化基础设施、信息系统建设及信息技术应用、信息标准与信息共享、信息化安全、信息化效益等6个一级指标、15个二级指标及多个评价内容。 ⑵构建了湖北省乡镇卫生院信息化水平评价指标体系和评价细则湖北省乡镇卫生院信息化水平评价指标体系主要包括信息化保障体系、信息化基础设施、信息系统功能及应用、信息标准与共享、信息化安全、信息化效益等6个一级指标、18个二级指标及多个评价内容。 ⑶构建了湖北省村卫生室信息化水平评价指标体系和评价细则湖北省村卫生室信息化水平评价指标体系主要包括硬件设施建设、信息系统功能与应用、信息交换与共享、管理制度与措施、村医信息化能力等5个一级指标、9个二级指标及多个评价内容。 [结论]构建的湖北省县域医疗卫生机构信息化水平评价指标体系层次分明，评价方法合理，具备良好的可操作性，能够较全面地反映湖北省县域医疗卫生机构信息化建设的水平，为构建全国的县域医疗卫生信息化水平评价指标体系提供重要参考，具有推广应用价值。创新之处 ⑴评价对象方面经相关数据库和搜索引擎查询，未见乡镇卫生院、村卫生室等机构的信息化水平评价指标体系及相关研究。本项目研究设计的湖北省乡镇卫生院、村卫生室等信息化水平评价指标体系，填补了基层医疗卫生机构信息化水平评价指标体系研究领域的空白。本项目构建的湖北省乡镇卫生院、村卫生室信息化水平评价指标体系对开展全国乡镇卫生院、村卫生室信息化水平评价同样具有重要的借鉴和参考价值。 ⑵评价方法方面本项目评价指标体系的构建采用分级评价方法，该方法比常规的利用德尔菲法和层次分析法确定指标权重系数方法更具可比性和可操作性。本项目在参考卫生部《电子病历系统功能应用水平分级评价方法及标准（试行）》研究成果的基础上，首次将分级评价方法引入医疗卫生机构全面的信息化水平评价，在机构信息化水平整体评价的方法上具有较好的创新性。不足之处 ⑴本项目确定的分级评价指标体系目前按其重要性和实现难易程度划分为四个级别，分别对应于优、良、合格、不合格，进一步研究还可增加级别数量以增强区分度，以便于更精确地区分信息化建设水平。 ⑵由于认识上的偏差，有可能导致个别评价指标级别的划分和归属与信息化建设水平实际情况存在一定偏离。 ⑶本项目设计的评价指标体系拟用于湖北省县域医疗卫生机构的信息化水平评价，但由于种种原因目前尚未投入正式实际应用，实际应用后可根据实测数据进一步修改和完善指标体系。
[Abstract]:The informatization construction of grass-roots medical institutions is an important part of the reform of the medical and health system, is an important technical support and guarantee for the deepening reform of the State Council. "" 12th Five-Year "during the period of deepening medical and health system planning and implementation plan" (Guo Fa 2012 No. 11) clearly put forward to accelerate the grassroots medical and health institutions in the pilot information. On the basis of the province as a unit, the establishment of basic medical health information system, improve the level of medical and health services. The national development and Reform Commission, the basic medical and health institutions management information system of the Ministry of health jointly issued the "construction project guidance" clearly stated: to 2015 gradually built.2010 information system covering urban and rural basic medical institutions in the national investment 1 billion 890 million construction of the Midwest 423 thousand village clinics, primary health care in 2011 has invested 1 billion 250 million of the 31 provinces. Management information system construction.
In the capital and national construction under the support of the national policy, the informatization construction of basic medical and health institutions at present is showing a rapid development trend. In order to promote the medical and health institutions at county level in Hubei province information construction and management, improve the informatization construction of the grass-roots medical institutions should use the quality and level of the establishment of a scientific and rational, objective and fair, informatization level evaluation index system medical and health institutions at county level in Hubei province and convenient operation has become the key problem to be solved.
[] the purpose of this study to the national policy as a guide, in order to investigate the status of hospital informatization in Hubei province > < pre project (E Wei 2010 Letter No. 179) as the basis, combined with the county of Hubei Province medical institutions informationization construction present situation, from the relevant research results at home and abroad, adhere to the advanced, comparability, operability. Oriented indicators such as construction principle, explore the establishment of evaluation for the informatization level of medical and health institutions at county level in Hubei province model, index system, evaluation methods and evaluation rules for evaluation of informatization level of medical and health institutions at county level in Hubei Province.
[method] through literature and field research method to analyze the construction of informatization evaluation in Jianhu County North of medical and health institutions and the initial model index database; focus group discussion, the application of informatization evaluation of medical and health institutions at county level in Hubei Province, and revise and improve the initial model and index database; using the expert meeting method and key performance indicators selection of indicators and determine the evaluation methods.
The construction of informatization level in county hospitals in Hubei province evaluation index system and evaluation rules].
The evaluation index system of informatization level of county hospitals in Hubei province including information security system, information infrastructure, information system construction and application of information technology, information standards and information sharing, information security, information efficiency of 6 level indicators, 15 level two indexes and multiple evaluation content.
The construction of the level of township hospitals in Hubei province information evaluation index system and evaluation rules.
The evaluation index system of the level of township hospitals in Hubei province information including information security system, information infrastructure, information function and application system, information standards and information security, information sharing, benefit 6 level indicators, 18 level two indexes and multiple evaluation contents.
The construction of the informatization level of Hubei Province, village health evaluation index system and evaluation rules.
The evaluation index system of the information level of village clinics in Hubei province mainly consists of 5 primary indexes, namely, hardware facilities construction, information system function and application, information exchange and sharing, management system and measures, information capacity of village doctors, 9 two level indicators and multiple evaluation contents.
The level of informatization level evaluation index system of medical and health institutions at county level in Hubei province to build the clear conclusion], the evaluation method is reasonable, good maneuverability, can comprehensively reflect the information construction of medical and health institutions of county level of Hubei Province, and provide an important reference for the construction of the county health informatization evaluation index system, has the value of popularization and application.
Innovation
The evaluation object
The related database and search engine queries, township hospitals no village health institutions such as the informatization evaluation index system and related research. The township hospitals in Hubei province to study the design of this project, the evaluation index system of informatization level of the village health room, to fill the gaps in the field of basic medical and health institutions informatization level evaluation index system the township hospitals in Hubei province. The project construction, the informatization level of village health evaluation index system of the township hospital, also has an important reference value for evaluating the informatization level of village clinics.
The evaluation method
Construction of hierarchical evaluation index system of the project, the method to determine the index weight coefficient method is more comparable and workable than Delphy Fa analysis and AHP method with conventional. The project evaluation and the standard price method in the classification of electronic medical records system reference to the Ministry of health "function application level (Trial) > basic research achievements on the evaluation of informatization level for the first time grading evaluation method into medical and health institutions, comprehensive, innovative good method in evaluation of the overall level of information.
Deficiencies
The evaluation index system of classification of the project to determine the current according to the degree of difficulty and realize its importance is divided into four levels, respectively, corresponding to the excellent, good, qualified, unqualified, further research can also increase the level of quantity to enhance the discrimination, in order to more accurately distinguish the level of informatization construction.
Due to the deviation of understanding, may lead to the individual evaluation index level classification and attribution and the level of informatization construction actual situation exists some deviation.
The design of this project evaluation index system for evaluation of informatization level of medical and health institutions at county level in Hubei Province, but due to various reasons has not been put into practical application, the application can modify and improve the index system according to the measured data.

【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R197-39

【参考文献】