以全科医生为主体的校园学生健康管理模式探讨  

General Practitioner Based Mode for Students Health Management at Campus

作　　者：何丹丹[1] 赵燕萍[1] 苏华林[1] 白庆瑞[2] 张鑫毅[1] 应圣洁[1] 宫志敏[1] 赵乾坤 辛峰[1] 尉敏琦[1] 鲍勇[3] 

机构地区：[1]上海市闵行区疾病预防控制中心,201101 [2]上海市疾病预防控制中心 [3]上海交通大学医学院公共卫生学院

出　　处：《中国全科医学》2014年第1期84-87,共4页Chinese General Practice

基　　金：上海市教育委员会科研创新项目:基于社会公平性的社区卫生服务模式比较研究(09ZS121);国家自然科学基金:基于患者信任的医疗服务质量改进研究(70973078);上海市卫生局课题:上海实施家庭医生制度的研究(2010HP007)

摘　　要：目的探讨建立以全科医生为主体的校园学生健康管理模式,并了解其实践效果。方法健康管理模式包括:建立以全科医生为主体的学生健康管理网络;建立医校联动的学生健康管理工作机制,制定质量控制指标;建立学生电子健康档案与健康管理信息网络平台及信息化绩效管理工作机制。通过分析不同学段、病种的学生的干预效果和健康素养问卷调查来评估健康管理的效果。结果闵行区所有中小学校2011学年在校学生共120 221名,发放健康卡并建立电子健康档案113 872份,建档率为94.72%。全科医生共发现疾病并建卡23 674份,管理35 740人次,管理率为99.73%。不同学段学生的累积干预效果、最近一次干预效果比较,差异均有统计学意义(H值分别为42.859、28.888,P<0.05);不同病种学生的累积干预效果、最近一次干预效果比较,差异均有统计学意义(H值分别为802.101、568.189,P<0.05)。不同学段学生的健康素养问卷得分比较,差异有统计学意义(F=141.490,P<0.05)。以正确应答率≥80%为具备健康素养,不同学段学生的健康素养具备率比较,差异有统计学意义(χ2=268.500,P<0.05)。结论建立完善的校园全科医生工作网络,明确工作职责,依托信息化网络平台,能有效开展学生的健康管理工作。Objective To establish the model of student health management at campus that takes general practitioners as the mainstay and explore its practical effects. Methods The health management model developed included establishing network of students＇ health management taking general practitioners as the mainstay, working mechanism for students＇ health management co - operated by medical and school parties with formulation of quality control indicators, student electronic health records, health management information network platform, and informatization performance management mechanism. The effect of health management model was assessed through the intervention of the students with different kinds of diseases and at different grades as well as questionnaire survey on health literacy. Results The number of primary and secondary school students in Minhang District of Shanghai was 120 221 in 2011. The number of issued health cards with electronic health records was 113 872, with a record - establishing rate of 94.72%. A total of 23 674 disease cards had been established and the managed person - time by general practitioners was 35 740, with a managing rate of 99. 73%. The accumulating intervention effects and the latest intervention effects among different grades showed significant differences （H = 42. 859, 28. 888, P 〈 0. 05）, and so did among different kinds of diseases （H = 802. 101, 568. 189, P 〈 0. 05） . There was significant difference in score of health literacy rate among students at difference grades （F = 141. 490, P 〈 0. 05） . Taking the correct answer rate≥ 80% as having health literacy, the health literacy rates among students at different grades showed significant difference （x2 = 268. 500, P 〈0. 05） . Conclusion To improve campus network for general practitioners＇ work and to determine their job duties can effectively promote the work of student health management by relying on the informatization network platform.

关 键 词：健康管理 全科医生 中小学生卫生保健服务 电子健康档案 

分 类 号：R197[医药卫生—卫生事业管理]