我国医联体内医疗机构信息化建设现状调研

A Cross-Sectional Investigation on Informatization Construction of Medical Institutions in the Medical Alliance in China

目的 了解我国医联体内医疗机构信息化建设现状。方法 采用网络问卷调研法,对参与医联体建设的医疗机构进行分阶段分层抽样调查,所得数据使用Microsoft Excel和SPSS 21.0软件进行统计分析。结果 调研医疗机构来自我国东、中、西部地区16个省(自治区、直辖市)。医联体类型为县域医共体最多(66.17%),政策引导参与医联体建设占比最高(68.20%),医疗机构自筹资金占比最高(72.62%)。81.56%的医疗机构开展分级诊疗业务,74.49%的医疗机构开展远程医疗业务。约80%的医疗机构独立进行运行管理,其中医保支付管理信息化支撑占比最高(达34.61%)。74.37%的医疗机构独自进行网络安全建设,仅14.83%的医疗机构完成所有系统的定级备案。55.32%的医疗机构未启动数据安全工作。建设与维护信息化平台的主要困难是资金投入不足(84.36%)。结论 我国医联体内医疗机构信息化建设在规范标准、信息安全意识、资金与人才保障等方面存在不足。建议以需求和应用为导向,落实网络安全防护保障措施,制定智慧医联体建设标准,以推进医联体信息化建设。

Objective To understand the current situation of information construction of medical institutions in medical alliance in China. Methods An online questionnaire was used to conduct a phased stratified sampling survey for the medical institutions participating in the construction of medical alliance. The data were statistically analyzed by Microsoft Excel and SPSS 21.0 software. Results The medical institutions were from 16 provinces(autonomous regions and municipalities) in the eastern, central and western regions of China. The types of medical alliances was the most in county medical cooperatives(66.17%), policy-guided participation in the construction of medical alliances accounted for the highest proportion(68.20%), and self-financing of medical institutions accounted for the highest proportion(72.62%). 81.56% of medical institutions carried out hierarchical diagnosis and treatment, and 74.49% of medical institutions carried out telemedicine. About 80% of medical institutions operated and managed independently, among which the information support of medical insurance payment management accounted for the highest proportion(34.61%). 74.37% of medical institutions independently built network security, and only 14.83% of medical institutions completed the grading and filing of all systems. 55.32% of medical institutions did not start data security work. The main difficulty in building and maintaining the information platform was insufficient capital investment(84.36%). Conclusion There were still some deficiencies in the construction of medical institutions informatization in the medical alliance in China, such as standard, information security awareness, capital and talent guarantee. It was suggested that demand-oriented and application-oriented, network security safeguard measures should be implemented, and the construction standards of smart medical alliances should be formulated to promote the informatization construction of medical alliances.