中国西部地区农村重性精神病患者健康管理现状调查:问题及对策分析

发布时间：2018-03-03 05:17

本文选题：农村地区　切入点：重性精神病　出处：《中国全科医学》2014年23期 　论文类型：期刊论文

【摘要】：目的调查农村重性精神病患者健康管理现状,发现存在的问题并进行对策分析。方法 2014年3—4月对四川省郫县农村地区6家基层医疗卫生机构管理的790例重性精神病患者健康管理状况进行调查,同时访谈30例基层公共卫生人员和6例公共卫生服务评审检查专家。收集农村重性精神病患者健康管理情况,通过讨论、分析目前存在的问题。结果 790例重性精神病患者中,男433例(54.8%),女357例(45.2%);年龄5~96岁,平均47.4岁。在不同年龄组中35~64岁年龄段所占比例最大(454/790,57.5%);在不同疾病类型中精神分裂症所占比例最大(511/790,64.7%),其次是精神发育迟滞伴发精神障碍(242/790,30.6%)。基层机构开展了排查工作,坚持"应管尽管",为所有确诊患者建立了健康档案。706例(89.4%)患者接受过每年至少4次随访;患者危险性评级为:0级290例(36.7%),1级451例(57.1%),2级37例(4.7%),3级1例(0.1%),未评等级11例(1.4%)。以《国家基本公共卫生服务规范(2011年版)》(以下简称《国家规范》)为分析依据,目前健康管理存在四方面问题:健康档案记录不规范;健康管理服务的分类干预不规范;基层卫生机构精神卫生服务能力严重不足,专业人才缺乏;部分患者及其家属配合程度低。结论农村基层医疗卫生机构开展了重性精神病健康管理工作,但管理能力不足,档案管理不规范,患者配合度不高,管理实效欠佳。建议创新农村重性精神病患者综合防治管理机制以提升管理实效,加强《国家规范》培训以进一步提升基层机构服务能力,加强指导、质控和督导检查工作以确保做实重性精神病患者服务工作,加大精神卫生健康教育宣传和患者帮扶减免力度以提升患者及其家属配合度。
[Abstract]:Objective to investigate the status of health management in rural patients with severe mental illness. Methods in 2014, 790 patients with severe mental illness were investigated in 6 primary medical and health institutions in Pixian County, Sichuan Province, from March to March. At the same time, 30 primary public health workers and 6 public health service assessment and inspection experts were interviewed. The health management of rural patients with severe mental illness was collected, and the existing problems were analyzed through discussion. Results among 790 patients with severe mental illness, There were 433 men, 54.8%, and 357 women, 45.2%; the age was 5 to 96 years old. The average age group was 47.4 years old. In different age groups, the age group of 35 or 64 had the largest proportion of 454 / 79057.50.The proportion of schizophrenia was 511 / 79064.7in different disease types, followed by mental retardation with mental retardation (242r79030.6.). (B) insist on "notwithstanding" and establish a health file for all confirmed patients .706 / 89.4) patients have been followed up at least four times a year; The risk rating of the patients was 290 cases of grade 0, 36.7 cases, 451 cases of grade 1, 57.1 grade, 37 cases of grade 2, 37 cases of grade 4. 7, 1 case of grade 3, 1 case of grade 1, 1 case of grade 1, and 11 cases of unassessed grade, based on the National Standard for basic Public Health Services (2011 Edition) (hereinafter referred to as "National Standards") as the basis of analysis. At present, there are four problems in health management: the record of health file is not standardized, the classified intervention of health management service is not standardized, the ability of mental health service in primary health institutions is seriously insufficient, and the professional personnel are lacking; Conclusion Primary medical and health institutions in rural areas have carried out major mental health management work, but the management ability is insufficient, the file management is not standardized, and the cooperation degree of patients is not high. It is suggested to innovate the management mechanism of comprehensive prevention and treatment of severe mental patients in rural areas in order to enhance the effectiveness of management, strengthen the training of "National Standard" so as to further enhance the service capacity of grass-roots institutions and strengthen the guidance. Quality control and supervision and inspection work to ensure that the major mental health care services, strengthen mental health education and relief of patients to enhance the cooperation of patients and their families.
【作者单位】：成都中医药大学管理学院;
【基金】：国家社科基金项目(12BJY092)——西部地区农村居民医疗消费现状及政策研究
【分类号】：R749

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