医院病案信息管理中存在的问题及对策分析  

Problems and countermeasures analysis of hospital medical record information management

作　　者：程玉[1] 

机构地区：[1]陕西省商洛市疾病预防控制中心,陕西商洛726000

出　　处：《临床医学研究与实践》2017年第19期197-198,共2页Clinical Research and Practice

摘　　要：目的探讨医院病案信息管理中存在的问题及相应的解决对策。方法选择2014年4月至2015年4月收治的110例患者作为对照组,实施传统的常规病案信息管理方法,选择2015年5月至2016年5月收治的110例患者作为观察组,实施新的病案信息管理方法。对比两组患者病案信息管理中的问题发生率,以及患者对医院医疗及护理服务的满意度。结果观察组患者病案信息管理中问题发生率为7.27%(8/110),低于对照组的30.91%(34/110),差异具有统计学意义(P<0.05);观察组患者对医疗及护理服务的满意度为95.45%(105/110),高于对照组的80.91%(89/110),差异具有统计学意义(P<0.05)。结论针对医院病案信息管理中存在的问题及不足,采取相应的对策并实施新的病案信息管理方法,能够取得更为理想的效果。Objective To study the existing problems and corresponding countermeasures in hospital medical record information management. Methods A total of 110 cases of patients who implemented routine medical record information management from April 2014 to April 2015 were selected as the control group, and 110 cases of patients who implemented new medical record information management from May 2015 to May 2016 were selected as the observation group. The incidence rate of medical record information management problems and satisfaction rate of medical and nursing services were compared between the two groups. Results The incidence rate of medical record information management problems in the observation group was 7.27% （8/110）, which was lower than 30.91% （34/110） in the control group （P〈0.05）. The satisfaction rate of medical and nursing services in the observation group was 95.45% （105/110）, which was higher than 80.91% （89/ 110） in the control group （P〈0.05）. Conclusion In the hospital medical record and information management, aiming at the existing problems and shortcomings to take corresponding measures and implement new medical record information management can obtain more ideal clinical effect.

关 键 词：病案信息管理 问题 对策 

分 类 号：R197.323[医药卫生—卫生事业管理]