崇义县农村居民健康档案管理存在的问题及对策

Problems and strategies of health record management for rural residents living at Chongyi county

目的探索农村居民健康档案管理存在的关键问题并提出完善对策，为我国农村居民健康档案管理工作提供借鉴。方法以崇义县为例，分别对乡镇卫生院的医务人员、乡村医生和建立健康档案的农民进行问卷调查，并采用利用焦点组访谈和鱼骨图分析法进一步验证调查的结果。结果崇义县农村居民健康档案工作仅有对农村居民进行体检的每人20元的补助，而建一份档案的成本至少是55．5元，其中体检经费需要42．7元，因此，经费投入明显不足；在建立健康档案108个乡村中，配备电脑的仅有60个，设备明显缺乏；乡镇卫生院的医护人员相当缺乏，每千农业人口乡镇卫生院人员仅为1．49人；工作人员积极性不高、农村居民认识不足、健康档案缺乏规范管理及对档案利用不足。结论应加大政府投入、提高居民健康档案意识，建立完善的管理制度与信息系统并加强培训来完善农村居民健康档案管理工作。

Objective To explore the key problems facing health record management and put forward effective strategies. Methods Questionnaires survey was performed among county medical staff, country doctors and rural residents who had medical records. Fishbone diagram was used to justify the results. Results At Chongyi county, rural residents got 20-Yuan subsidy per person for medical examine, although the establishment of a health file cost at least 55.5 Yuan, including 42.7 Yuan for medical examination. Only 60 of 108 villages were equipped with computers. Medical staff account for 1.49/1000. The awareness and use of health records were insufficient. Conclusion Our data suggest that it should be necessary to increase financial investment, enhance knowledge on health records, put electronic information system into practice, and strengthen personnel training in the future.