本文選題：縣域醫(yī)療衛(wèi)生機(jī)構(gòu)　切入點(diǎn)：信息化水平評價(jià)　出處：《華中科技大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：基層醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)是醫(yī)藥衛(wèi)生體制改革的重要內(nèi)容之一，是深化醫(yī)改的重要技術(shù)支撐和保障。國務(wù)院《“十二五”期間深化醫(yī)藥衛(wèi)生體制改革規(guī)劃暨實(shí)施方案》（國發(fā)〔2012〕11號）明確提出加快推進(jìn)基層醫(yī)療衛(wèi)生機(jī)構(gòu)信息化，在試點(diǎn)基礎(chǔ)上，以省為單位，建立基層醫(yī)療衛(wèi)生信息系統(tǒng)，提高基層醫(yī)療衛(wèi)生服務(wù)水平。國家發(fā)改委、衛(wèi)生部聯(lián)合印發(fā)的《基層醫(yī)療衛(wèi)生機(jī)構(gòu)管理信息系統(tǒng)建設(shè)項(xiàng)目指導(dǎo)意見》明確提出：到2015年逐步建成覆蓋城鄉(xiāng)基層醫(yī)療衛(wèi)生機(jī)構(gòu)的信息系統(tǒng)。2010年國家投入18.9億進(jìn)行中西部42.3萬個(gè)村衛(wèi)生室信息化建設(shè)，2011年又投入12.5億進(jìn)行31個(gè)省的基層醫(yī)療衛(wèi)生機(jī)構(gòu)管理信息系統(tǒng)建設(shè)。 在國家政策及國家建設(shè)資金的支持下，目前基層醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)正呈現(xiàn)快速發(fā)展的態(tài)勢。為促進(jìn)湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)和管理，提高基層醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)質(zhì)量和應(yīng)用水平，研究建立科學(xué)合理、客觀公正、操作簡便的湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平評價(jià)指標(biāo)體系已成為當(dāng)前亟待解決的關(guān)鍵問題。 [目的]本研究以國家政策為指導(dǎo)，以前期項(xiàng)目《湖北省醫(yī)院信息化現(xiàn)狀調(diào)查》（鄂衛(wèi)函〔2010〕179號）為基礎(chǔ)，結(jié)合湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)現(xiàn)狀，借鑒國內(nèi)外相關(guān)研究成果，堅(jiān)持先進(jìn)性、可比性、可操作性、導(dǎo)向性等指標(biāo)構(gòu)建原則，，探索建立適合湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平的評價(jià)模型、指標(biāo)體系、評價(jià)方法和評價(jià)細(xì)則，用于湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平的測評。 [方法]通過文獻(xiàn)分析法和現(xiàn)場調(diào)研法構(gòu)建湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平評價(jià)模型和初始指標(biāo)庫；應(yīng)用專題小組討論法商榷湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平評價(jià)方法，并修改和完善初始模型和指標(biāo)庫；運(yùn)用專家會議法和關(guān)鍵績效指標(biāo)法篩選優(yōu)化指標(biāo)并確定評價(jià)方法。 [結(jié)果]⑴構(gòu)建了湖北省縣級醫(yī)院信息化水平評價(jià)指標(biāo)體系和評價(jià)細(xì)則 湖北省縣級醫(yī)院信息化水平評價(jià)指標(biāo)體系主要包括信息化保障體系、信息化基礎(chǔ)設(shè)施、信息系統(tǒng)建設(shè)及信息技術(shù)應(yīng)用、信息標(biāo)準(zhǔn)與信息共享、信息化安全、信息化效益等6個(gè)一級指標(biāo)、15個(gè)二級指標(biāo)及多個(gè)評價(jià)內(nèi)容。 ⑵構(gòu)建了湖北省鄉(xiāng)鎮(zhèn)衛(wèi)生院信息化水平評價(jià)指標(biāo)體系和評價(jià)細(xì)則 湖北省鄉(xiāng)鎮(zhèn)衛(wèi)生院信息化水平評價(jià)指標(biāo)體系主要包括信息化保障體系、信息化基礎(chǔ)設(shè)施、信息系統(tǒng)功能及應(yīng)用、信息標(biāo)準(zhǔn)與共享、信息化安全、信息化效益等6個(gè)一級指標(biāo)、18個(gè)二級指標(biāo)及多個(gè)評價(jià)內(nèi)容。 ⑶構(gòu)建了湖北省村衛(wèi)生室信息化水平評價(jià)指標(biāo)體系和評價(jià)細(xì)則 湖北省村衛(wèi)生室信息化水平評價(jià)指標(biāo)體系主要包括硬件設(shè)施建設(shè)、信息系統(tǒng)功能與應(yīng)用、信息交換與共享、管理制度與措施、村醫(yī)信息化能力等5個(gè)一級指標(biāo)、9個(gè)二級指標(biāo)及多個(gè)評價(jià)內(nèi)容。 [結(jié)論]構(gòu)建的湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平評價(jià)指標(biāo)體系層次分明，評價(jià)方法合理，具備良好的可操作性，能夠較全面地反映湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)信息化建設(shè)的水平，為構(gòu)建全國的縣域醫(yī)療衛(wèi)生信息化水平評價(jià)指標(biāo)體系提供重要參考，具有推廣應(yīng)用價(jià)值。 創(chuàng)新之處 ⑴評價(jià)對象方面 經(jīng)相關(guān)數(shù)據(jù)庫和搜索引擎查詢，未見鄉(xiāng)鎮(zhèn)衛(wèi)生院、村衛(wèi)生室等機(jī)構(gòu)的信息化水平評價(jià)指標(biāo)體系及相關(guān)研究。本項(xiàng)目研究設(shè)計(jì)的湖北省鄉(xiāng)鎮(zhèn)衛(wèi)生院、村衛(wèi)生室等信息化水平評價(jià)指標(biāo)體系，填補(bǔ)了基層醫(yī)療衛(wèi)生機(jī)構(gòu)信息化水平評價(jià)指標(biāo)體系研究領(lǐng)域的空白。本項(xiàng)目構(gòu)建的湖北省鄉(xiāng)鎮(zhèn)衛(wèi)生院、村衛(wèi)生室信息化水平評價(jià)指標(biāo)體系對開展全國鄉(xiāng)鎮(zhèn)衛(wèi)生院、村衛(wèi)生室信息化水平評價(jià)同樣具有重要的借鑒和參考價(jià)值。 ⑵評價(jià)方法方面 本項(xiàng)目評價(jià)指標(biāo)體系的構(gòu)建采用分級評價(jià)方法，該方法比常規(guī)的利用德爾菲法和層次分析法確定指標(biāo)權(quán)重系數(shù)方法更具可比性和可操作性。本項(xiàng)目在參考衛(wèi)生部《電子病歷系統(tǒng)功能應(yīng)用水平分級評價(jià)方法及標(biāo)準(zhǔn)（試行）》研究成果的基礎(chǔ)上，首次將分級評價(jià)方法引入醫(yī)療衛(wèi)生機(jī)構(gòu)全面的信息化水平評價(jià)，在機(jī)構(gòu)信息化水平整體評價(jià)的方法上具有較好的創(chuàng)新性。 不足之處 ⑴本項(xiàng)目確定的分級評價(jià)指標(biāo)體系目前按其重要性和實(shí)現(xiàn)難易程度劃分為四個(gè)級別，分別對應(yīng)于優(yōu)、良、合格、不合格，進(jìn)一步研究還可增加級別數(shù)量以增強(qiáng)區(qū)分度，以便于更精確地區(qū)分信息化建設(shè)水平。 ⑵由于認(rèn)識上的偏差，有可能導(dǎo)致個(gè)別評價(jià)指標(biāo)級別的劃分和歸屬與信息化建設(shè)水平實(shí)際情況存在一定偏離。 ⑶本項(xiàng)目設(shè)計(jì)的評價(jià)指標(biāo)體系擬用于湖北省縣域醫(yī)療衛(wèi)生機(jī)構(gòu)的信息化水平評價(jià)，但由于種種原因目前尚未投入正式實(shí)際應(yīng)用，實(shí)際應(yīng)用后可根據(jù)實(shí)測數(shù)據(jù)進(jìn)一步修改和完善指標(biāo)體系。
[Abstract]:The informatization construction of grass-roots medical institutions is an important part of the reform of the medical and health system, is an important technical support and guarantee for the deepening reform of the State Council. "" 12th Five-Year "during the period of deepening medical and health system planning and implementation plan" (Guo Fa 2012 No. 11) clearly put forward to accelerate the grassroots medical and health institutions in the pilot information. On the basis of the province as a unit, the establishment of basic medical health information system, improve the level of medical and health services. The national development and Reform Commission, the basic medical and health institutions management information system of the Ministry of health jointly issued the "construction project guidance" clearly stated: to 2015 gradually built.2010 information system covering urban and rural basic medical institutions in the national investment 1 billion 890 million construction of the Midwest 423 thousand village clinics, primary health care in 2011 has invested 1 billion 250 million of the 31 provinces. Management information system construction.
In the capital and national construction under the support of the national policy, the informatization construction of basic medical and health institutions at present is showing a rapid development trend. In order to promote the medical and health institutions at county level in Hubei province information construction and management, improve the informatization construction of the grass-roots medical institutions should use the quality and level of the establishment of a scientific and rational, objective and fair, informatization level evaluation index system medical and health institutions at county level in Hubei province and convenient operation has become the key problem to be solved.
[] the purpose of this study to the national policy as a guide, in order to investigate the status of hospital informatization in Hubei province > < pre project (E Wei 2010 Letter No. 179) as the basis, combined with the county of Hubei Province medical institutions informationization construction present situation, from the relevant research results at home and abroad, adhere to the advanced, comparability, operability. Oriented indicators such as construction principle, explore the establishment of evaluation for the informatization level of medical and health institutions at county level in Hubei province model, index system, evaluation methods and evaluation rules for evaluation of informatization level of medical and health institutions at county level in Hubei Province.
[method] through literature and field research method to analyze the construction of informatization evaluation in Jianhu County North of medical and health institutions and the initial model index database; focus group discussion, the application of informatization evaluation of medical and health institutions at county level in Hubei Province, and revise and improve the initial model and index database; using the expert meeting method and key performance indicators selection of indicators and determine the evaluation methods.
The construction of informatization level in county hospitals in Hubei province evaluation index system and evaluation rules].
The evaluation index system of informatization level of county hospitals in Hubei province including information security system, information infrastructure, information system construction and application of information technology, information standards and information sharing, information security, information efficiency of 6 level indicators, 15 level two indexes and multiple evaluation content.
The construction of the level of township hospitals in Hubei province information evaluation index system and evaluation rules.
The evaluation index system of the level of township hospitals in Hubei province information including information security system, information infrastructure, information function and application system, information standards and information security, information sharing, benefit 6 level indicators, 18 level two indexes and multiple evaluation contents.
The construction of the informatization level of Hubei Province, village health evaluation index system and evaluation rules.
The evaluation index system of the information level of village clinics in Hubei province mainly consists of 5 primary indexes, namely, hardware facilities construction, information system function and application, information exchange and sharing, management system and measures, information capacity of village doctors, 9 two level indicators and multiple evaluation contents.
The level of informatization level evaluation index system of medical and health institutions at county level in Hubei province to build the clear conclusion], the evaluation method is reasonable, good maneuverability, can comprehensively reflect the information construction of medical and health institutions of county level of Hubei Province, and provide an important reference for the construction of the county health informatization evaluation index system, has the value of popularization and application.
Innovation
The evaluation object
The related database and search engine queries, township hospitals no village health institutions such as the informatization evaluation index system and related research. The township hospitals in Hubei province to study the design of this project, the evaluation index system of informatization level of the village health room, to fill the gaps in the field of basic medical and health institutions informatization level evaluation index system the township hospitals in Hubei province. The project construction, the informatization level of village health evaluation index system of the township hospital, also has an important reference value for evaluating the informatization level of village clinics.
The evaluation method
Construction of hierarchical evaluation index system of the project, the method to determine the index weight coefficient method is more comparable and workable than Delphy Fa analysis and AHP method with conventional. The project evaluation and the standard price method in the classification of electronic medical records system reference to the Ministry of health "function application level (Trial) > basic research achievements on the evaluation of informatization level for the first time grading evaluation method into medical and health institutions, comprehensive, innovative good method in evaluation of the overall level of information.
Deficiencies
The evaluation index system of classification of the project to determine the current according to the degree of difficulty and realize its importance is divided into four levels, respectively, corresponding to the excellent, good, qualified, unqualified, further research can also increase the level of quantity to enhance the discrimination, in order to more accurately distinguish the level of informatization construction.
Due to the deviation of understanding, may lead to the individual evaluation index level classification and attribution and the level of informatization construction actual situation exists some deviation.
The design of this project evaluation index system for evaluation of informatization level of medical and health institutions at county level in Hubei Province, but due to various reasons has not been put into practical application, the application can modify and improve the index system according to the measured data.

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R197-39

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