江苏省基层医疗卫生机构信息化建设与使用情况研究

The Informatization Construction and Use of Primary Health Institutions in Jiangsu Province

背景“十三五”时期,我国基层卫生信息化建设发展迅速,对基层医疗服务水平和服务质量提升有很大促进作用,但在某些方面仍存在不足。目的了解江苏省基层医疗卫生机构的信息化建设和使用情况,发现尚存问题,并提出相应对策。方法于2020年7—10月,采用分层随机抽样法,在江苏省13个设区市抽取500家基层医疗卫生机构开展问卷调查。问卷主要内容为基层医疗卫生机构信息化建设的财政规划与经费来源、医院信息系统建设与使用情况、居民健康档案建立与开放共享情况、运维人员配置情况、医疗信息共享情况、远程医疗开展情况、对基层信息化的满意度等。由样本机构的业务(副)院长根据机构的实际情况填写问卷。结果最终共获得基层医疗卫生机构有效问卷416份,占全省基层医疗卫生机构总数的26.5%(416/1567)。80.0%(333/416)的基层医疗卫生机构信息化建设由县(市、区)级政府统一规划,67.3%(280/416)的经费来自各级财政支持。99.0%(412/416)的基层医疗卫生机构建有医院信息管理系统,92.1%(383/416)建有门诊医生工作站,81.7%(340/416)建有电子病历系统,45.0%(187/416)建有临床信息系统。98.3%(409/416)的基层医疗卫生机构已实现健康档案信息化,31.3%(130/416)的基层医疗卫生机构电子健康档案向居民开放。83.9%(349/416)的基层医疗卫生机构可以与下属社区卫生服务站/村卫生室共享患者诊疗信息,14.2%(59/416)的基层医疗卫生机构可以看到医联体上级单位对患者的诊疗信息,29.1%(121/416)的基层医疗卫生机构实现患者信息在县(市、区)范围内的共享,4.3%(18/416)的基层医疗卫生机构实现患者信息在设区市的共享。38.2%(159/416)的基层医疗卫生机构开展了远程预约、心电图/CT检查诊断服务,15.6%(65/416)的基层医疗卫生机构开展了实时远程门诊/会诊服务。81.3%(338/416)的基层医疗卫生机构对信息化建设现状感到非常满意/满意。不同机构类型、不同设区市基层医疗卫生机构的信息化发展阻力、对基层信息化的满意度不同(P<0.05)。结论江苏省基层医疗卫生机构信息化整体发展较好,但仍然存在区域发展不平衡、跨区域信息难共享、远程医疗未普及等现象,有待进一步完善、改进。

Background During the 13th Five-Year Plan in China,the rapid development of the informatization construction in the primary health of China has greatly promoted the improvement of the service level and quality of the primary health institutions,but there are still deficiencies in some aspects.Objective To investigate the status of informatization construction of primary health institutions in Jiangsu Province,in order to analyze the existing problems and provide corresponding countermeasures.Methods From July to October 2020,a stratified random sampling method was used to select 500 primary health institutions from 13 cities in Jiangsu Province to carry out a questionnaire survey.The contents of the questionnaire included the financial planning and fund sources for infomatization construction of the primary health institutions,status of information system construction of hospitals,the informatization of residents'health records,the deployment of informatization staffs,medical information sharing,status of telemedicine and satisfaction to the informationization of the primary health institutions.The vice president of business filled in the questionnaire according to the truth.Results A total of 416 valid questionnaires from the primary health institutions were obtained,accounting for 26.5%(416/1567)of all the primary health institutions in the province.80.0%(333/416)of the informatization construction of primary health institutions is planned by the county(city,district)government,and 67.3%(280/416)got fund from the government finance.99.0%(412/416)of the primary health institutions constructed hospital information management system,92.1%(383/416)constructed outpatient system,81.7%(340/416)constructed electronic medical record system,45.0%(187/416)constructed clinical information system,98.3%(409/416)constructed information system of residents'health records.31.3%(130/416)of the primary health institutions shared medical information to the patients,83.9%(349/416)shared the medical information to the community health service station and the village clinics,14.2%(59/416)shared the medical information to the superior hospitals,29.1%(121/416)shared the medical information over the county,4.3%(18/416)shared the medical information over the city.38.2%(159/416)of the primary health institutions carried out such services as online appointment,ECG or CT diagnosis,and 15.6%(65/416)carried out real-time outpatient service.81.3%(338/416)of the primary health institutions showed satisfaction to the informatization construction,and the institutions with different types or in different cities showed different satisfaction.Conclusion The overall informatization of primary health institutions in Jiangsu is is relatively good,but there are still phenomena such as unbalanced regional development,low level of cross-regional information sharing and lack of popularization of telemedicine,which needs to be further improved.