四川省基层医疗卫生管理信息系统健康档案管理模块的使用现状分析  

Analysis on the Current Situation of Using Health Record Management Module in Sichuan Primary Medical and Health Management Information System

作　　者：彭艳秋 刘润友[1] 李羚[1] 杨长虹[1] 吕强[1] PENG Yanqiu;LIU Runyou;LI Ling;YANG Changhong;LYU Qiang(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《职业卫生与病伤》2021年第6期378-385,共8页Occupational Health and Damage

基　　金：四川省基层卫生事业发展研究中心项目(项目编号:SWFZ18-Y-8)。

摘　　要：目的了解四川省基层医疗卫生管理信息系统中"健康档案管理模块"在基层医疗卫生机构中的使用现状,为促进和健全健康档案建设提供参考。方法以四川省所有县(区、市)为单位,等比例单纯随机抽取基层医疗卫生机构共1026个,采用网络问卷法对医院健康档案信息管理人员开展调查。使用SPSS 20.0软件进行卡方检验,以P<0.05为差异有统计学意义。结果被调查医疗机构的"基层系统"健康档案管理模块使用率构为99.56%(914/918),健康档案建档率达100%的医疗机构占53.90%(493/914),其中街道卫生院为32.0%(158/305)、中心卫生院为16.8%(83/164)、乡卫生院为46.2%(228/373)、社区卫生服务中心为4.9%(24/72);健康档案保存方式以纸质与电子并存为主(826/90.4%),电子化保存率(8.50%)较低;从事健康档案管理工作人员的专业分布以临床(371/40.6%)和护理(363/39.7%)为主;居民健康体检开展频次以每年1次(748/81.8%)为主;医疗机构网络稳定性(285/31.2%)和网络速度(502/55.0%)较差;四类医疗机构在建档率、存档方式、档案管理人员专业分布、健康体检频次和网络稳定性和网络速度上差异有统计学意义(P<0.05);流动人口、居民健康意识淡薄、居民健康认知差异、居民考虑健康信息隐私保护是影响建档率的重要因素(P<0.05)。结论四川省基层医疗卫生机构在"基层系统"中的健康档案建档率和电子化率低,从事健康档案管理的工作人员对自身的专业评价不足、基层硬件设施与网络限制、人口流动,对健康档案建立、管理和利用等各个环节造成压力。Objective To understand the current situation of“health records management module”using in Sichuan primary medical and health management information system in primary medical and health institutions,and to provide reference for promoting and improving health records construction.Methods A total of 1026 basic medical and health institutions were randomly selected from all counties(districts,cities)in Sichuan province with equal proportion.The network questionnaire was used to investigate the health records information management personnel in hospitals.SPSS20.0 software was used for chi-square test,P<0.05 was considered as statistically significant difference.Results 99.56%(914/918)usage of the“primary system”health record management module of the under surveyed medical institutions,53.90%(493/914)of the medical institutions with 100%health record filing rate.The rates were 32.0%(158/305)in sub-district health centers,16.8%(83/164)in central health centers,46.2%(228/373)in rural health centers,and 4.9%(24/72)in community health service centers.Using paper and electronic health records at the same time was the mainly way of preservation(826/90.4%),and the rate of electronic health records was low(8.50%).The professional distribution of health records management staffs were mainly clinical(371/40.6%)and nursing(363/39.7%)majors.The frequency of residents′health examination was mainly once a year(748/81.8%).The network stability(285/31.2%)and network speed(502/55.0%)of medical institutions were poor.There were statistically significant differences among the four types of medical institutions in the filing rate,archiving method,professional distribution of archives management personnel,health examination frequency,network stability and network speed(P<0.05).Floating population,weak health awareness of residents,differences in health cognition and consideration of health information privacy protection of residents were the important factors affecting the filing rate(P<0.05).Conclusion The rate of health record

关 键 词：基层医疗卫生机构 健康档案 基层医疗 信息系统 

分 类 号：R197[医药卫生—卫生事业管理]