학술논문
妇幼保健机构质量安全管理现状分析 / Quality and safety management of maternal and child health care institutions
Document Type
Academic Journal
Author
Source
中国妇幼健康研究 / Chinese Journal of Woman and Child Health Research. 29(2):196-199
Subject
Language
Chinese
ISSN
1673-5293
Abstract
目的 对已完成"四大部制"建设的妇幼保健机构质量安全管理现状进行分析,为进一步改善妇幼保健机构的医疗和服务质量提供依据.方法 针对2016年已完成孕产保健部、儿童保健部、妇女保健部和计划生育技术服务部"四大部制"建设的262所妇幼保健机构进行调查,通过全国妇幼保健机构监测管理信息网络报告系统收集相关数据,从机构人力资源、工作效率、工作负荷、诊疗质量、患者安全和院感防控对省市县三级妇幼保健机构进行分析.结果 省级妇幼保健机构新生儿总住院死亡率为3.33‰,高于其他两级机构,差异存在统计学意义(χ2=75.79,P<0.05),与国内研究3.11‰差距不大.省级妇幼保健机构的平均住院日7.4天,床位使用率97.8% 均超出国家要求;其医师日均担负门诊人次9.8、住院床日3.0天,均高于省属综合医院的8.6人次和2.6天;人员工作负荷较重.地市级妇幼保健机构新生儿医院总感染发生率为2.83% 高于其他两级机构,差异存在统计学意义(χ2=1079.67,P< 0.05),同时高于相关资料中儿童专科医院的感染率1.25%.县区级妇幼保健机构剖宫产率最低为36.28%,差异存在统计学意义(χ2=328.75,P<0.05),仍略高于2014年全国妇幼卫生年报的34.9%.结论 各级妇幼保健机构在医疗保健服务质量安全管理方面仍然存在诸多薄弱环节,资源配置不足,人员工作负荷较重,尚需不断持续改进,提升服务质量和服务水平.
Objective To analyze the quality and safety management of maternal and child health institutions which have completed construction of"four major departments"and to provide basis for further improving medical treatment and service quality of maternal and child health care institutions.Methods Investigation was carried out in 262 maternal and child health institutions which completed construction of four major departments,including maternal health care department,child health care department, women's health care department and family planning technical service department in 2016.Data were collected through monitoring and management information network reporting system of national maternal and child health institutions,and provincial,municipal and county level maternal and child health institutions were analyzed from the aspects of human resources,work efficiency, workload,quality of diagnosis and treatment,patient safety and hospital infection prevention and control.Results Neonatal in-hospital mortality of provincial level maternal and child health institutions was 3.33‰,which was higher than that of other two level institutions,and difference was statistically significant(χ2=75.79,P<0.05).This neonatal in-hospital mortality had little difference from that of 3.11‰ in domestic research.Average hospital stay was 7.4 days and utilization rate of beds was 97.8% in provincial maternal and child health institutions,and both exceeded national requirements.Every physician received an average of 9.8 people daily,and average duration of hospitalization of patient was 3.0 days,which were both higher than 8.6 people and 2.6 days respectively in provincial general hospital,showing that staff had heavy work load in provincial maternal and child health institutions.Neonatal hospital infection incidence of municipal maternal and child health institutions was 2.83%,which was higher than that of other two level institutions,and difference was statistically significant(χ2=1 079.67,P<0.05),and also higher than that of 1.25% in children's specialist hospitals recorded in relevant articles.Lowest cesarean section rate in county level maternal and child health institutions was 36.28%,which had statistically significant difference compared with other two level institutions (χ2=328.75,P<0.05),and still slightly higher than that of 34.9% in 2014 national annual report on maternal and child health. Conclusion Maternal and child health care institutions still have many weak links in quality and safety management of health care services.Continuous improvement in resource allocation and heavy workload of staff are necessary for improving quality and level of service.
Objective To analyze the quality and safety management of maternal and child health institutions which have completed construction of"four major departments"and to provide basis for further improving medical treatment and service quality of maternal and child health care institutions.Methods Investigation was carried out in 262 maternal and child health institutions which completed construction of four major departments,including maternal health care department,child health care department, women's health care department and family planning technical service department in 2016.Data were collected through monitoring and management information network reporting system of national maternal and child health institutions,and provincial,municipal and county level maternal and child health institutions were analyzed from the aspects of human resources,work efficiency, workload,quality of diagnosis and treatment,patient safety and hospital infection prevention and control.Results Neonatal in-hospital mortality of provincial level maternal and child health institutions was 3.33‰,which was higher than that of other two level institutions,and difference was statistically significant(χ2=75.79,P<0.05).This neonatal in-hospital mortality had little difference from that of 3.11‰ in domestic research.Average hospital stay was 7.4 days and utilization rate of beds was 97.8% in provincial maternal and child health institutions,and both exceeded national requirements.Every physician received an average of 9.8 people daily,and average duration of hospitalization of patient was 3.0 days,which were both higher than 8.6 people and 2.6 days respectively in provincial general hospital,showing that staff had heavy work load in provincial maternal and child health institutions.Neonatal hospital infection incidence of municipal maternal and child health institutions was 2.83%,which was higher than that of other two level institutions,and difference was statistically significant(χ2=1 079.67,P<0.05),and also higher than that of 1.25% in children's specialist hospitals recorded in relevant articles.Lowest cesarean section rate in county level maternal and child health institutions was 36.28%,which had statistically significant difference compared with other two level institutions (χ2=328.75,P<0.05),and still slightly higher than that of 34.9% in 2014 national annual report on maternal and child health. Conclusion Maternal and child health care institutions still have many weak links in quality and safety management of health care services.Continuous improvement in resource allocation and heavy workload of staff are necessary for improving quality and level of service.