《民法典》背景下北京市严重精神障碍发病报告制度研究  

Implementation Analysis of Severe Mental Illness Reporting System in Beijing during the Execution of the Civil Code of the People’s Republic of China

作　　者：王昊旻[1] 李筱永[1] 姬雨童 WANG Haomin;LI Xiaoyong;JI Yutong(Department of Health Law,School of Medical Humanities,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学医学人文学院卫生法学学系,北京市100069

出　　处：《中国全科医学》2021年第17期2127-2133,共7页Chinese General Practice

基　　金：北京市社会科学基金重点项目:风险预警背景下北京市严重精神障碍发病报告制度研究(18FXA001)。

摘　　要：背景精神卫生属于国家重大公共卫生问题。在积极推进精神卫生事业发展,保障公民健康权益的基础上,对于北京市严重精神障碍发病报告制度的运行实施进行相关研究。目的了解北京市严重精神障碍发病报告制度的实施状况及存在的问题,以期提供对于该制度的完善建议。方法2018年11月—2019年3月采用分层随机抽样法选取了北京市朝阳区、西城区、大兴区、房山区四区辖区社区卫生服务中心从事精神病防治管理的医生(简称精防医生)进行严重精神障碍发病报告制度相关问题问卷调查,回收有效问卷214份,采用SPSS 25.0统计软件进行多重响应分析及χ^(2)拟合优度检验。采取文献研究法,梳理有关该制度的最新规定及其他学者对于相关问题的研究理论。结果接受问卷调查的精防医生中有54.7%(117/214)认为严重精神障碍发病报告制度非常重要,35.1%(75/214)认为比较重要,认为该制度重要的占比高达89.8%(192/214)。精防医生对于该制度的风险预警、疾病监测、社区管理的主要作用认知所占比例比较,差异无统计学意义(χ^(2)=0.073,P=0.964)。15.9%(34/214)的精防医生认为该制度实施的效果非常好,50.9%(109/214)认为效果比较好,24.8%(53/214)认为一般,合计84.1%(180/214)的精防医生认为该制度并不完善,还有改进之处。精防医生对于该制度存在的问题所占比例比较,差异有统计学意义(χ^(2)=88.338,P<0.001),其中选择"涉及到患者隐私,患者不愿被知道自己有精神疾病"的最多,占比高达83.2%(178/214)。精防医生对于该制度完善建议选择比例比较,差异有统计学意义(χ^(2)=13.579,P=0.019),其中选择"规范信息收集、登记、更正、汇总制度"最多,占比高达76.6%(164/214),选择"规范信息共享及对患者隐私保护的制度"次之,占比达67.3%(144/214)。结论严重精神障碍发病报告制度涉及对于患者隐私权的限制,尚存在不完善�Background Mental health is a major national public health issue.To actively promote the development of mental health services to safeguard the health rights and interests of citizens,we studied the implementation of serious mental illness reporting system in Beijing.Objective To explore the implementation of severe mental illness reporting system in Beijing,and identify and analyze the problems,providing suggestions for the improvement of the system.Methods From November 2018 to March 2019,we conducted a questionnaire survey regarding the implementation of severe mental illness reporting system with psychiatrists(assuming duties of delivering mental illness prevention and management services)selected by stratified random sampling methodfrom community health centers in Beijing’s Chaoyang,Xicheng,Daxing and Fangshan Districts.Multiple response analysis and Chi-square goodness-of-fit test were performed using SPSS 25.0.Literature review was performed to find the latest provisions of the system and other scholars’research theories on related issues.Results In total,214 cases who returned responsive questionnaires were included for final analysis.Among the respondents,54.7%(117/214)thought the system was very important,and 35.1%(75/214)thought it was relatively important,the proportion was 89.8%(192/214)in total.The proportions of respondents knowing the role played by the system in mental illness risk warning,surveillance and community-based management were not statistically different(χ^(2)=0.073,P=0.964).The implementation effectiveness of the system was rated as excellent,relatively good,and fair by 15.9%(34/214),50.9%(109/214),and 24.8%(53/214)of the respondents,respectively.But 84.1%(180/214)of the respondents thought that the system was not very sound and needed improvements.The proportions of respondents choosing different problems existing in the implementation of the system were statistically different(χ^(2)=88.338,P<0.001).The proportion of respondents choosing"Considering personal privacy,the patient

关 键 词：严重精神障碍发病报告制度 卫生政策 精神障碍 民法典 隐私权 

分 类 号：R-01[医药卫生] R74