上海市民营医疗机构概况及传染病报告与管理现况调查

发布时间：2019-02-14 22:08

【摘要】：研究背景近几年,传染病重新受到社会关注,且受重视程度逐年上升。传染病报告及管理是传染病防治工作的重要组成部分,卫生部为此多次下发相关文件,并通过建立网络直报平台的方式进行传染病信息的收集。与此同时,我国民营医疗机构尤其是在作为发达地区的上海市,本世纪以来民营医疗机构获得了长足的发展。但是尚未见有针对民营医疗机构传染病报告及管理现况的数据支撑及相关调查。因此,为了提升上海市传染病的整体防控水平,掌握本市民营医疗机构概况、传染病报告质量及管理现况,建立、健全民营医疗机构传染病报告及管理制度是当务之急。研究目的了解上海市民营医疗机构的概况、传染病报告及管理现况,发现存在问题,探求合理合法的民营医疗机构传染病防治工作方法,为有关部门拟定本市民营医疗机构在传染病报告及管理的规章制度提供依据,探讨其发展前景,进而整体提升上海市医疗机构的传染病报告质量和防治工作管理水平。研究方法通过普查与抽样调查相结合、定量与定性调查相结合、调查问卷与自填问卷相结合、经常性资料与访谈相结合的方法进行资料收集。对抽样机构相关业务人员进行问卷调查,对临床医生和传染病报告人员进行传染病相关知识自填问卷调查,对分管领导、临床医生和传染病报告人员进行访谈。定量资料以Epidata软件建立数据库,采用Excel、SPSS软件,根据资料类型和数据分布特征采用相应的统计学方法进行描述与推断；定性资料进行类属分析。研究结果 1.上海市民营医疗机构共计1083家,规模及硬件设置参差不齐。 2.民营医疗机构传染病管理相关文件整理与落实情况较差,均未开展传染病相关的课题研究；医院传染病报告专职人员、管理制度设置、落实比例明显高于门诊部及私人诊所。 3.民营医疗机构传染病报告基础登记及报告质量开展较差,报告及时率92.72%,重卡率1.10%,明显低于公立医疗机构。 4.民营医疗机构临床医生及传染病报告人员对传染病防治法及传染病报告知晓率较差,其中私人诊所最低；不同科室、学历、职称、是否参加过培训的人员的知晓率无明显差别,培训开展效果不佳。 5.民营医疗机构对传染病报告及管理不够重视,未能全面理解传染病防治法及传染病报告管理相关文件精神；卫生行政部门、疾病预防控制部门、卫生监督部门对民营医疗机构的指导与监督不平衡,重视监督忽略督导。讨论与建议上海市民营医疗机构规模参差不齐,分级不明确,基本配置、人力资源、传染病管理制度设置情况不一；传染病报告质量低于公立医疗机构,相关知晓率差；卫生管理部门重视对机构的督导、忽略对机构的培训与指导；医疗机构自身对于传染病报告及管理的重视程度不高。建议卫生行政部门及相关管理部门明确民营医疗机构的审批标准、创建传染病报告环境；有针对性地开展包括培训在内的各项管理工作,调整现有方案并注重文件的执行力；提升报告质量及传染病报告人员、临床医生的传染病管理与报告相关知晓率,规范报告行为；平衡对民营及公立医疗机构的管理、培训、监督与反馈；同时,医疗机构自身应调整传染病报告及管理的思路与观念。
[Abstract]:Study Background In recent years, infectious diseases have been re-paid to the attention of the society, and the degree of attention has been increasing year by year. The report and management of infectious diseases are an important part of the prevention and control of infectious diseases. The Ministry of Health has issued the relevant documents for many times, and receives the information of the infectious diseases through the establishment of the network direct report platform. At the same time, the private medical institution in our country, especially in Shanghai as a developed area, has made great development since this century However, the data support and related adjustment for the status of infectious disease reporting and management of the private medical institutions have not been met. Therefore, in order to improve the overall prevention and control level of the infectious disease in Shanghai, the general situation of the private medical institutions of the city, the quality of the report of the infectious disease and the status of the management, the establishment and improvement of the report and management system of the infectious diseases of the private medical institutions shall be established. I'm in a hurry. The purpose of this study is to know the general situation of the private medical institution in Shanghai, the report of the infectious disease and the current situation of the management, and to find out the problems and to seek the rational and lawful prevention of the infectious diseases of the private medical institution. According to the working methods, the relevant departments shall formulate the rules and regulations for the reporting and management of the infectious diseases of the private medical institutions of the city, and probe into the development prospect, so as to improve the quality of the infectious diseases and the prevention and treatment of the infectious diseases of the medical institutions in Shanghai as a whole. to manage water The research method is combined with the sampling survey, the quantitative and qualitative survey, the questionnaire is combined with the self-filling questionnaire, and the regular data is combined with the interview. The data collection is carried out by the method of the relevant business personnel of the sampling institution, and the relevant knowledge of the clinical doctors and the infectious disease reporting personnel shall be self-filled with the questionnaire, and the leaders, the clinical doctors and the transmission of the infectious diseases shall be conducted. According to the data type and data distribution characteristics, the corresponding statistical methods are used to describe and infer the data. sex data entry Analysis of the line type. Results 1. The total number of private medical institutions in Shanghai is 1083. The family, scale and hardware settings are uneven. 2. The related documents of the management of infectious diseases in the private medical institutions are not subject to the related problems related to the infectious diseases. The special-purpose personnel of the hospital infectious disease report and the management system shall set and fall. The real proportion is obviously higher than that of the outpatient department and the private clinic. 3. The registration of the basic registration of the infectious disease report of the private medical institution and the quality of the report are poor, the report shall be reported in a timely rate of 92.72%, and the heavy card The rate is 1. 10%, which is obviously lower than that of the public medical institution. The awareness rate of the personnel is not obvious, and the effect of the training is not good. 5. The private medical institution has insufficient attention to the reporting and management of the infectious diseases, and fails to fully understand the related document spirit of the prevention and control of the infectious diseases and the management of the infectious disease report; the health administrative department, the disease prevention and control department and the guard The health supervision department is concerned with the private medicine a finger of a therapeutic mechanism The guidance and supervision are not balanced, and the supervision and neglect supervision is attached to the supervision. The discussion and suggestion are that the scale of the private medical institutions in Shanghai is uneven, the classification is not clear, the basic configuration, the human resources and the infectious disease management system are set up. Not one; the quality of the infectious disease report is lower than that of the public medical institution, the relevant awareness rate is poor; the health management department attaches importance to the supervision of the institution, and ignores the training and the finger of the institution It is suggested that the health administrative departments and relevant management departments should make clear the examination and approval standards of the private medical institutions, create the reporting environment of infectious diseases, and carry out the activities in a targeted manner. The management work, including the training, adjust the existing scheme and pay attention to the execution of the documents; improve the reporting quality and the infectious disease report personnel, the infectious disease management of the clinical doctor and the related awareness rate of the report, and standardize the reporting behavior; Balance the management, training, supervision and feedback of the private and public medical institutions
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R181.8

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