合肥市社区卫生服务机构慢性病防治能力建设的现况研究
Study on the current situation of the prevention and control of chronic diseases in Hefei community health agency
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摘要: 目的:了解目前合肥市社区卫生服务机构慢性病防治工作,慢性病防治人员对慢性病知识的掌握情况。方法:抽取合肥市每个行政区中约80%的社区卫生服务机构,通过自拟问卷调查这些机构慢性病防治的人、财、物现状,慢性病防治人员培训及其慢性病防治知识的掌握情况,以及慢性病工作开展能力的状况。结果:抽取的150家社区卫生服务机构中,仅26家(17.3%)设有慢性病科,参与慢性病防治的人员占技术人员的比例为35.3%;2008年,25.3%的机构没有慢性病防治经费,并且慢性病防治经费不超过2万元的机构达40.7%;94.7%的机构建立了纸质健康档案,仅有66.0%进行了分析;50.0%的机构建有档案基础信息系统,但均未使用,均为上级部门帮助建立。调查的567名慢性病防治人员中,文化程度和第学历均以高中专和大专为主,参与慢性病防治工作的年限为2.0年(P50),职称为初级及以下的占78.6%;其中,参加了慢性病知识培训的人员达80.6%,但培训级别主要为县级和市级。在慢性病知识测试中,慢性病防治人员在恶性肿瘤和心脑血管病防治知识上的得分低于高血压和糖尿病防治知识;参加过慢性病防治培训和慢性病工作年限在4年以上人员的慢性病知识得分均高于没有参加过培训和工作年限在4年以下者(P=0.006和P=0.010)。结论:合肥市社区卫生服务机构慢性病防治工作在机构建设和队伍建设上力度都有所加强,但与国家平均水平和部分地区相比,仍有差距,应进步加强慢性病防治能力的建设,从政策、经费、人员等方面给予支持。Abstract: Objective:To investigate the prevention and control of chronic diseases in Hefei community health service agency,and the knowledge the staffs in charge have acquired about the prevention and control of chronic diseases.Methods:A total of one hundred and fifty community health service agencies which had been chosen from eighty percent of the community health service agencies in each district in Hefei seven administrative districts were investigated by self-made questionnaires.About the human resources,financial situation,current work capacity,personnel training and the knowledge they had acquired in the prevention and control of chronic diseases.Results:Among the 150 agencies,only 17.3%(26 agencies) had set a chronic disease department;the staffs involved in the prevention and control of chronic diseases account for 35.3% of the technicians;25.3% of these agencies did not have funds for the prevention and control of chronic diseases in 2008,and 40.7% had funds less than 20 000 yuan.Ninety-four point seven percent of the agencies had set up health records typed in paper,but only 66.0% had been analyzed.Fifty percent of the archives foundational information systems which had been established with the help of superior departments had never been used ever since.Majority of the 567 people investigated had graduated from the secondary or higher vocational colleges,and had engaged in chronic diseases for only two years(P50);78.6% of them possessed junior titles or below;80.6% of them had participated the prevention and control of chronic disease training,in county or city.The staffs made less correct answers in tests about malignant tumor and cardiovascular disease than in high blood pressure and diabetes mellitus apparently.People who had received professional training or had worked for over 4 years scored higher in the test than those who had not(P=0.006 and P=0.010).Conclusions:The organization construction and personnel building about the prevention and control of chronic diseases in Hefei community health services have improved greatly.However,when compared with the national average level and some areas,the difference is still significant.The prevention and control of chronic diseases should be strengthened and supports such as funds,policy and personnel should be provided.