本文選題：基層醫(yī)療市場 + 基層醫(yī)療機構　； 參考：《山東大學》2017年碩士論文

【摘要】：研究背景隨著社會主義市場經(jīng)濟的迅速發(fā)展,醫(yī)療市場的逐步開放,社會上出現(xiàn)了多樣化的辦醫(yī)形式,在一定程度上滿足了人民群眾日益增長的醫(yī)療衛(wèi)生服務需求。但是,由于醫(yī)療衛(wèi)生體制改革中制度的不健全,一些單位或個人為追求經(jīng)濟利益而置病人的生命健康權益于不顧,無證行醫(yī)、超出核準的診療科目執(zhí)業(yè)、使用非衛(wèi)生技術人員從事醫(yī)療衛(wèi)生技術工作、消毒不嚴格、醫(yī)療廢物處置不當?shù)冗`法行為,極大地破壞了正常的醫(yī)療服務市場秩序,嚴重危害了人民群眾的健康權益及生命安全�；鶎俞t(yī)療市場的主體為基層醫(yī)療機構�；鶎俞t(yī)療機構是各級各類醫(yī)療機構的重要組成部分,承擔了大部分的基本醫(yī)療和基本公共衛(wèi)生服務任務,直接關系到基層廣大人民群眾的身心健康。基層醫(yī)療市場無證行醫(yī)的多寡,基層醫(yī)療機構能否依法執(zhí)業(yè),與群眾切身利益息息相關。因此加強對基層醫(yī)療市場的監(jiān)督和管理,規(guī)范基層醫(yī)療機構的執(zhí)業(yè)行為,對于規(guī)范醫(yī)療市場秩序、保障醫(yī)療安全等具有重要的意義。市級衛(wèi)生監(jiān)督機構每年開展的醫(yī)療市場暗訪活動,是對轄區(qū)內(nèi)基層醫(yī)療市場存在的各類違法行為進行監(jiān)督的有效手段。通過對醫(yī)療市場暗訪的數(shù)據(jù)進行分析,找出當前基層醫(yī)療市場存在的違法行為,各類違法行為在哪些場所或機構多發(fā),據(jù)此探討出針對性的監(jiān)管對策,同時,也為衛(wèi)生行政部門及衛(wèi)生監(jiān)督機構調(diào)整醫(yī)療衛(wèi)生監(jiān)督政策、改進監(jiān)管措施提供借鑒和參考。研究目的分析2013-2015年某市暗訪基層醫(yī)療機構的違法情況;分析2013-2015年某市涉醫(yī)單位的違法情況;根據(jù)存在的問題,提出相應的對策與建議。資料與方法資料來源于2013-2015年某市衛(wèi)生監(jiān)督所對所轄區(qū)范圍內(nèi)的基層醫(yī)療市場暗訪的登記歸檔資料。登記歸檔的暗訪基層醫(yī)療機構和涉醫(yī)場所共303家。其中2013年72家,2014年84家,2015年147家。對存檔的暗訪資料進行整理,將相關的數(shù)據(jù)輸入Excel表格,建立數(shù)據(jù)庫,利用SPSS進行統(tǒng)計分析。統(tǒng)計學指標采用了違法率和構成比。為確保數(shù)據(jù)錄入準確,采用兩人同時錄入,并逐一核對錄入數(shù)據(jù)。主要結果1.基層醫(yī)療服務市場中,無證行醫(yī)情況嚴重,無證行醫(yī)占到所有暗訪單位的48.8%。2.基層醫(yī)療機構中,違法數(shù)量最多的是:村衛(wèi)生室、西醫(yī)診所、衛(wèi)生所(室),分別占 25.8%、18.1%、14.2%。3.使用非衛(wèi)生技術人員從事醫(yī)療衛(wèi)生技術工作的違法發(fā)生率高達48.4%,主要分布在衛(wèi)生所(室)、社區(qū)衛(wèi)生服務機構、西醫(yī)診所、中西醫(yī)診所和口腔診所。西醫(yī)診所和社區(qū)衛(wèi)生服務機構超范圍執(zhí)業(yè)問題最為嚴重,違法率均為28.6%。4.基層醫(yī)療機構的處方書寫,除了衛(wèi)生院、醫(yī)療美容診所外,其他所有醫(yī)療機構都存在違法,違法率高達68.4%以上。5.基層醫(yī)療機構的消毒管理違法率高達82.6%,醫(yī)療廢物處置違法率為80.6%。村衛(wèi)生室、衛(wèi)生所是高發(fā)單位。6.無證行醫(yī)的涉醫(yī)場所中,口腔診所、推拿按摩場所數(shù)量最多,分別占 41.2%、11.2%。7.在涉醫(yī)單位中,普遍進行了違法宣傳,藥店、生活美容場所、推拿按摩理療場所的違法率分別為100%、83.3%、82.3%。8.70.9%的無證行醫(yī)場所分布在鄉(xiāng)鎮(zhèn)。對策與建議1.以涉醫(yī)口腔診所、無證行醫(yī)多發(fā)的鄉(xiāng)鎮(zhèn)為監(jiān)督重點,堅持疏堵結合、打防并舉的工作方法。2.理順衛(wèi)生監(jiān)督機構體制機制,合理配置衛(wèi)生監(jiān)督員。3.加強對基層醫(yī)療機構消毒及醫(yī)療廢物的管理。4.以不良執(zhí)業(yè)行為記分管理為抓手,加強對重點違法行為、違法多發(fā)機構的監(jiān)管。5.大力培訓基層醫(yī)療機構工作人員,強化依法執(zhí)業(yè)意識。6.嚴把審批許可關,加強規(guī)范化診所建設和依法執(zhí)業(yè)公示臺工作。7.進一步建立健全醫(yī)療衛(wèi)生法律法規(guī),盡快出臺衛(wèi)生基本法。8.加強醫(yī)學基本知識及醫(yī)療衛(wèi)生法律法規(guī)的宣傳與普及。
[Abstract]:With the rapid development of the socialist market economy, the gradual opening up of the medical market and the emergence of a diversified form of medical service in society, the research background has met the growing demand for medical and health services to a certain extent. However, some units or individuals are pursuing the unsound system in the reform of the medical and health system. With regard to the interests of the patients, the health rights and interests of the patients are ignored, the unlicensed practice of medicine, the practice beyond the approved medical treatment subjects, the use of non hygienic technical personnel to engage in medical and health technical work, unsterilizing and improper disposal of medical waste, have greatly destroyed the normal medical service market order and seriously endanger the people. Health rights and life safety. The main body of the medical market at the grass-roots level is primary medical institutions. Basic medical institutions are important components of all kinds of medical institutions at all levels. Most of the basic medical and basic public health services have been undertaken, directly related to the physical and mental health of the people at the grass-roots level. The basic medical market is unlicensed to practice medicine. Whether or not the grass-roots medical institutions can practise according to law is closely related to the vital interests of the masses. Therefore, it is of great significance to strengthen the supervision and management of the medical market at the grass-roots level and standardize the practice behavior of the grass-roots medical institutions, and to standardize the order of the medical market and ensure the medical safety. The medical market of the municipal health supervision institutions is dark every year. The visit is an effective means to supervise all kinds of illegal activities in the grass-roots medical market in the area. Through the analysis of the data of the medical market, we can find out the illegal behavior in the current medical market, and which places or institutions are more frequent in the illegal activities. For the health administration department and the health supervision organization to adjust the health supervision policy and improve the supervision measures to provide reference and reference. The purpose of this study is to analyze the illegal situation of the 2013-2015 years' visit to the grass-roots medical institutions in a city, and to analyze the illegal situation of the medical units in one city for the last 2013-2015 years, and put forward the corresponding countermeasures and suggestions according to the existing problems. Materials and methods were derived from the registration documents of the primary medical market in the area under the jurisdiction of a municipal health supervision institute in 2013-2015 years. The registered archived visits to grass-roots medical institutions and medical sites were 303. Among them, 72 in 2013, 84 in 2014 and 147 in 2015. Enter the Excel form, establish a database and use SPSS to carry out statistical analysis. The statistical index adopts the illegality rate and the ratio of composition. In order to ensure the accuracy of data entry, two people are recorded at the same time, and the data are checked and recorded one by one. The main result is that in the 1. basic medical service market, the unlicensed practice of medicine is serious, and the unlicensed medical service accounts for all the 48.8%. visiting units. 2. among the grass-roots medical institutions, the most illegal activities are: village health rooms, Western medical clinics, and health services (rooms), accounting for 25.8%, 18.1% respectively. The illegal occurrence rate of 14.2%.3. using non health technicians in medical and health technology is up to 48.4%, mainly in the health service (room), community health service, Western medical clinics, Chinese and Western medical clinics and oral cavity. Medical clinics, Western medical clinics and community health service institutions have the most serious problems. The illegal rate is written by the 28.6%.4. basic medical institutions. In addition to the health centers and the medical and beauty clinics, all other medical institutions are illegal, and the illegal rate up to 68.4% of the.5. medical institutions is up to 82.6%, The illegal rate of medical waste disposal is 80.6%. village health room, and the health institute is the place where the high incidence unit.6. does not permit medical treatment. The number of the oral clinics and massage places is the most, accounting for 41.2% respectively. In the medical unit, 11.2%.7. has generally carried out illegal propaganda, drugstores, living beauty places, and massage therapy places with 100%, 8 respectively. 3.3%, the unlicensed practice places of 82.3%.8.70.9% are distributed in the villages and towns. Countermeasures and suggestions 1. take the medical oral clinics, the villages and towns which have no evidence to have multiple medical treatment as the supervision key, adhere to the combination of dredging, and prevent the same work method.2. to straighten out the system mechanism of the health supervision institution, and rationally allocate the health supervisor.3. to strengthen the disinfection and medical waste to grass-roots medical institutions. The management of material management.4. takes the score management of bad practice behavior as the grasp, strengthening the key illegal behavior and the supervision of the illegal multiple agencies,.5. vigorously trains the staff of the grass-roots medical institutions, strengthens the practice consciousness of the law and strictly controls the approval of the examination and approval, strengthens the construction of standardized clinics and the work of the public demonstration station according to the law, and further establishes and improves the medical security. Health laws and regulations, the introduction of the basic law of health.8. as soon as possible, and strengthening the publicity and popularization of basic medical knowledge and laws and regulations.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1;D922.16

【參考文獻】

相關期刊論文 前10條

1 劉錦鈺;鄧小虹;董斯彬;戰(zhàn)捷;;實施醫(yī)療機構不良執(zhí)業(yè)行為積分管理的現(xiàn)狀分析[J];醫(yī)學教育管理;2016年02期

2 蔡聰勃;蘇玉城;王珊珊;盧劍航;;2009-2013年石獅市醫(yī)療機構消毒質量監(jiān)測結果分析[J];現(xiàn)代預防醫(yī)學;2015年06期

3 涂丹;何中臣;唐貴忠;;重慶市打擊無證行醫(yī)聯(lián)動機制運行現(xiàn)況調(diào)查[J];重慶醫(yī)學;2015年04期

4 陳長;;基層醫(yī)療機構管理中存在的問題與對策[J];江蘇衛(wèi)生事業(yè)管理;2014年04期

5 田建勇;;無證行醫(yī)行政處罰案件66起調(diào)查研究[J];山西醫(yī)藥雜志;2014年07期

6 江瀧;牛倉林;陳明;趙忠利;王建通;崔婭;;北京市豐臺區(qū)打擊無證行醫(yī)長效監(jiān)管機制探討[J];中國衛(wèi)生監(jiān)督雜志;2013年05期

7 徐曉霞;王明;任彥青;;鄒城市醫(yī)療廢物集中處置現(xiàn)況調(diào)查[J];中國公共衛(wèi)生管理;2011年04期

8 范磊;曾德才;褚紅輝;盛建明;;打擊非法行醫(yī)“行刑銜接”工作實踐分析[J];中國衛(wèi)生法制;2011年04期

9 白杰;王海青;宓錚;顧怡勤;;上海市閔行區(qū)打擊非法行醫(yī)的問題與對策[J];上海預防醫(yī)學;2011年01期

10 趙莉;何中臣;陳國強;唐貴忠;;對醫(yī)療衛(wèi)生監(jiān)督中相關法律問題的思考[J];現(xiàn)代預防醫(yī)學;2009年14期

，

本文編號：2116956