The Analysis Of Current Situation And Countermeasures Of Residents’ Health Records Implementation In Shandong Province

Background:To improve the level of public health services and accessibility.ensure all members of the community high health level,achieve the goal of health for all,in2009,the opinion of deepening medical and health system reform and the state council recent key implementation plan,it put forward to establish a unified standardized residents’ health records,the government provide money. Due to residents’health records project soon.there are some shortcomings.A policy has close relationship with its stakeholders.using the stakeholder analysis method to the research of current residents’ health records,it helpful to analysis the resistance and power of residents’ health records,then we put forward countermeasures to promote the sustainable development of residents’ health records.Objectives:Understand the status of the overall implementation of residents’ health records in Shandong province, compare residents’ health records implementation status between urban and rural, find the shortcomings in the health records management and implementation, use the stakeholder analysis methods to analyze the influence factors of residents’ health records, put forward the policy suggestions to promote the sustainable development of health records.Methods:According to completely random method randomly select30%of the county (city,area) as sample in17cities of Shandong province.select26areas and23counties in Shandong province as sample.According to the categories of grassroots medical and health service agencies,each area randomly select two community health service centers and two stations,each county randomly select two towns and two village clinics,all select52community health service centers,52community health service stations,46towns and46village clinics as samples. According to the national basic public health service specification,basic public health services experts formulate related indicators and questionnaire-basic public health services professionals make up search groups,after unified training conduct an investigation.Main Results:1. Overall implementation situation of residents’ health records in Shandong province:91.1%of organization’s management are good,system management is divided into bad,good and qualified three levels,ratio of2.2%,20%and77.8%respectively. Financial system management proportion are24.4%,28.9%and46.7%respectively. Financial management are8.9%,31.1%and60.0%respectively.The investigation of personnel only engaged in health records account for17.3%,there are23.1%of the staff for part-time. Formal schooling and title of health records personnel are on the low side,workload is big,income is not high. The residents’ health records by inputting rate is84.64%,reach the standard prescribed by the state. Health records by inputting rate more than50%is82.2%,electronic health records by inputting rate more than50%is48.9%,qualified health records rate more than90%is24.4%. Actual records account for73.2%of selected records,qualified records account for81.4%,83.7%of the records are in accordance with national standards.Child and maternal authenticity and eligibility ratio is higher. Residents’ overall satisfaction of basic public health services is88.9%.2. Comparative analysis between urban and rural residents health records: Organization management gap between urban and rural areas is not too big. Personnel mainly engaged in the urban community health records work account for48.43%in the investigators,rural is32.34%.Differences between urban and rural areas in health records personnel proportion is with statistical significance.Rural health records by inputting rate is higher than urban.Electronic health records by inputting rate has no much difference between urban and rural areas. Rural residents health records awareness is good to the city. Rural residents satisfaction is higher than city residents. The difference of health records authenticity between urban and rural the has statistical significance. The proportion of false records city is more than rural.but rural areas lost to follow-up seriously. The differences between urban and rural in health records of qualified rate are statistically significant.rural grassroots health institutions qualified rate is higher than city.3. Stakeholders of the residents’ health records are classified as major stakeholders, secondary stakeholders and external stakeholders. Major stakeholders include:the government,the public health administrative department,financial department, grassroots medical and health institutions, health workers and residents. Secondary stakeholders include:the centers for disease control/health supervision departments, hospitals, maternal and child health care institutions, kindergarten. External stakeholders:mental hospitals, elderly apartment, staff units, research institutions and enterprises.Countermeasures and Suggestions:Government level:Strengthen policy and financial support,actively building multi-sectoral cooperation mechanisms,strengthen the construction of legal system, promote the formation of the residents’ health records management innovation mechanism and perfect it. Grass-roots health institutions level:Improve the grassroots health institutions service ability. Health workers level:Improve personnel quality, give full play to the enthusiasm.Residents level:Promote the residents to participate in it,improve the residents compliance.