【摘要】：研究背景 近幾年,傳染病重新受到社會(huì)關(guān)注,且受重視程度逐年上升。傳染病報(bào)告及管理是傳染病防治工作的重要組成部分,衛(wèi)生部為此多次下發(fā)相關(guān)文件,并通過(guò)建立網(wǎng)絡(luò)直報(bào)平臺(tái)的方式進(jìn)行傳染病信息的收集。與此同時(shí),我國(guó)民營(yíng)醫(yī)療機(jī)構(gòu)尤其是在作為發(fā)達(dá)地區(qū)的上海市,本世紀(jì)以來(lái)民營(yíng)醫(yī)療機(jī)構(gòu)獲得了長(zhǎng)足的發(fā)展。但是尚未見(jiàn)有針對(duì)民營(yíng)醫(yī)療機(jī)構(gòu)傳染病報(bào)告及管理現(xiàn)況的數(shù)據(jù)支撐及相關(guān)調(diào)查。因此,為了提升上海市傳染病的整體防控水平,掌握本市民營(yíng)醫(yī)療機(jī)構(gòu)概況、傳染病報(bào)告質(zhì)量及管理現(xiàn)況,建立、健全民營(yíng)醫(yī)療機(jī)構(gòu)傳染病報(bào)告及管理制度是當(dāng)務(wù)之急。 研究目的 了解上海市民營(yíng)醫(yī)療機(jī)構(gòu)的概況、傳染病報(bào)告及管理現(xiàn)況,發(fā)現(xiàn)存在問(wèn)題,探求合理合法的民營(yíng)醫(yī)療機(jī)構(gòu)傳染病防治工作方法,為有關(guān)部門(mén)擬定本市民營(yíng)醫(yī)療機(jī)構(gòu)在傳染病報(bào)告及管理的規(guī)章制度提供依據(jù),探討其發(fā)展前景,進(jìn)而整體提升上海市醫(yī)療機(jī)構(gòu)的傳染病報(bào)告質(zhì)量和防治工作管理水平。 研究方法 通過(guò)普查與抽樣調(diào)查相結(jié)合、定量與定性調(diào)查相結(jié)合、調(diào)查問(wèn)卷與自填問(wèn)卷相結(jié)合、經(jīng)常性資料與訪談相結(jié)合的方法進(jìn)行資料收集。對(duì)抽樣機(jī)構(gòu)相關(guān)業(yè)務(wù)人員進(jìn)行問(wèn)卷調(diào)查,對(duì)臨床醫(yī)生和傳染病報(bào)告人員進(jìn)行傳染病相關(guān)知識(shí)自填問(wèn)卷調(diào)查,對(duì)分管領(lǐng)導(dǎo)、臨床醫(yī)生和傳染病報(bào)告人員進(jìn)行訪談。定量資料以Epidata軟件建立數(shù)據(jù)庫(kù),采用Excel、SPSS軟件,根據(jù)資料類(lèi)型和數(shù)據(jù)分布特征采用相應(yīng)的統(tǒng)計(jì)學(xué)方法進(jìn)行描述與推斷；定性資料進(jìn)行類(lèi)屬分析。 研究結(jié)果 1.上海市民營(yíng)醫(yī)療機(jī)構(gòu)共計(jì)1083家,規(guī)模及硬件設(shè)置參差不齊。 2.民營(yíng)醫(yī)療機(jī)構(gòu)傳染病管理相關(guān)文件整理與落實(shí)情況較差,均未開(kāi)展傳染病相關(guān)的課題研究；醫(yī)院傳染病報(bào)告專(zhuān)職人員、管理制度設(shè)置、落實(shí)比例明顯高于門(mén)診部及私人診所。 3.民營(yíng)醫(yī)療機(jī)構(gòu)傳染病報(bào)告基礎(chǔ)登記及報(bào)告質(zhì)量開(kāi)展較差,報(bào)告及時(shí)率92.72%,重卡率1.10%,明顯低于公立醫(yī)療機(jī)構(gòu)。 4.民營(yíng)醫(yī)療機(jī)構(gòu)臨床醫(yī)生及傳染病報(bào)告人員對(duì)傳染病防治法及傳染病報(bào)告知曉率較差,其中私人診所最低；不同科室、學(xué)歷、職稱(chēng)、是否參加過(guò)培訓(xùn)的人員的知曉率無(wú)明顯差別,培訓(xùn)開(kāi)展效果不佳。 5.民營(yíng)醫(yī)療機(jī)構(gòu)對(duì)傳染病報(bào)告及管理不夠重視,未能全面理解傳染病防治法及傳染病報(bào)告管理相關(guān)文件精神；衛(wèi)生行政部門(mén)、疾病預(yù)防控制部門(mén)、衛(wèi)生監(jiān)督部門(mén)對(duì)民營(yíng)醫(yī)療機(jī)構(gòu)的指導(dǎo)與監(jiān)督不平衡,重視監(jiān)督忽略督導(dǎo)。 討論與建議 上海市民營(yíng)醫(yī)療機(jī)構(gòu)規(guī)模參差不齊,分級(jí)不明確,基本配置、人力資源、傳染病管理制度設(shè)置情況不一；傳染病報(bào)告質(zhì)量低于公立醫(yī)療機(jī)構(gòu),相關(guān)知曉率差；衛(wèi)生管理部門(mén)重視對(duì)機(jī)構(gòu)的督導(dǎo)、忽略對(duì)機(jī)構(gòu)的培訓(xùn)與指導(dǎo)；醫(yī)療機(jī)構(gòu)自身對(duì)于傳染病報(bào)告及管理的重視程度不高。 建議衛(wèi)生行政部門(mén)及相關(guān)管理部門(mén)明確民營(yíng)醫(yī)療機(jī)構(gòu)的審批標(biāo)準(zhǔn)、創(chuàng)建傳染病報(bào)告環(huán)境；有針對(duì)性地開(kāi)展包括培訓(xùn)在內(nèi)的各項(xiàng)管理工作,調(diào)整現(xiàn)有方案并注重文件的執(zhí)行力；提升報(bào)告質(zhì)量及傳染病報(bào)告人員、臨床醫(yī)生的傳染病管理與報(bào)告相關(guān)知曉率,規(guī)范報(bào)告行為；平衡對(duì)民營(yíng)及公立醫(yī)療機(jī)構(gòu)的管理、培訓(xùn)、監(jiān)督與反饋；同時(shí),醫(yī)療機(jī)構(gòu)自身應(yīng)調(diào)整傳染病報(bào)告及管理的思路與觀念。
[Abstract]:Study Background In recent years, infectious diseases have been re-paid to the attention of the society, and the degree of attention has been increasing year by year. The report and management of infectious diseases are an important part of the prevention and control of infectious diseases. The Ministry of Health has issued the relevant documents for many times, and receives the information of the infectious diseases through the establishment of the network direct report platform. At the same time, the private medical institution in our country, especially in Shanghai as a developed area, has made great development since this century However, the data support and related adjustment for the status of infectious disease reporting and management of the private medical institutions have not been met. Therefore, in order to improve the overall prevention and control level of the infectious disease in Shanghai, the general situation of the private medical institutions of the city, the quality of the report of the infectious disease and the status of the management, the establishment and improvement of the report and management system of the infectious diseases of the private medical institutions shall be established. I'm in a hurry. The purpose of this study is to know the general situation of the private medical institution in Shanghai, the report of the infectious disease and the current situation of the management, and to find out the problems and to seek the rational and lawful prevention of the infectious diseases of the private medical institution. According to the working methods, the relevant departments shall formulate the rules and regulations for the reporting and management of the infectious diseases of the private medical institutions of the city, and probe into the development prospect, so as to improve the quality of the infectious diseases and the prevention and treatment of the infectious diseases of the medical institutions in Shanghai as a whole. to manage water The research method is combined with the sampling survey, the quantitative and qualitative survey, the questionnaire is combined with the self-filling questionnaire, and the regular data is combined with the interview. The data collection is carried out by the method of the relevant business personnel of the sampling institution, and the relevant knowledge of the clinical doctors and the infectious disease reporting personnel shall be self-filled with the questionnaire, and the leaders, the clinical doctors and the transmission of the infectious diseases shall be conducted. According to the data type and data distribution characteristics, the corresponding statistical methods are used to describe and infer the data. sex data entry Analysis of the line type. Results 1. The total number of private medical institutions in Shanghai is 1083. The family, scale and hardware settings are uneven. 2. The related documents of the management of infectious diseases in the private medical institutions are not subject to the related problems related to the infectious diseases. The special-purpose personnel of the hospital infectious disease report and the management system shall set and fall. The real proportion is obviously higher than that of the outpatient department and the private clinic. 3. The registration of the basic registration of the infectious disease report of the private medical institution and the quality of the report are poor, the report shall be reported in a timely rate of 92.72%, and the heavy card The rate is 1. 10%, which is obviously lower than that of the public medical institution. The awareness rate of the personnel is not obvious, and the effect of the training is not good. 5. The private medical institution has insufficient attention to the reporting and management of the infectious diseases, and fails to fully understand the related document spirit of the prevention and control of the infectious diseases and the management of the infectious disease report; the health administrative department, the disease prevention and control department and the guard The health supervision department is concerned with the private medicine a finger of a therapeutic mechanism The guidance and supervision are not balanced, and the supervision and neglect supervision is attached to the supervision. The discussion and suggestion are that the scale of the private medical institutions in Shanghai is uneven, the classification is not clear, the basic configuration, the human resources and the infectious disease management system are set up. Not one; the quality of the infectious disease report is lower than that of the public medical institution, the relevant awareness rate is poor; the health management department attaches importance to the supervision of the institution, and ignores the training and the finger of the institution It is suggested that the health administrative departments and relevant management departments should make clear the examination and approval standards of the private medical institutions, create the reporting environment of infectious diseases, and carry out the activities in a targeted manner. The management work, including the training, adjust the existing scheme and pay attention to the execution of the documents; improve the reporting quality and the infectious disease report personnel, the infectious disease management of the clinical doctor and the related awareness rate of the report, and standardize the reporting behavior; Balance the management, training, supervision and feedback of the private and public medical institutions
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R181.8

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