吉林衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)存在的問(wèn)題與對(duì)策,碩士論文

吉林衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)存在的問(wèn)題與對(duì)策,碩士論文目的：了解吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)提供的機(jī)構(gòu)設(shè)置、人員配置、培訓(xùn)和主要指標(biāo)的完成情況，了解基層工作人員碰到的困難和問(wèn)題，分析吉林省提供衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)服務(wù)的總體狀況，并針對(duì)存在的問(wèn)題討論解決的辦法，為提高衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)質(zhì)量提供根據(jù)和參考。方式方法：本研究通過(guò)收集吉林省各地區(qū)衛(wèi)生監(jiān)督所上報(bào)的衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)工作基本情況匯總表，以及對(duì)吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)工作人員發(fā)放基本情況調(diào)查問(wèn)卷的方式，對(duì)吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)進(jìn)行調(diào)查。采用描繪敘述性分析的方式對(duì)吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)的機(jī)構(gòu)設(shè)置、人員基本情況、培訓(xùn)情況和主要任務(wù)指標(biāo)的完成情況進(jìn)行分析。對(duì)所發(fā)放的354份調(diào)查問(wèn)卷中的內(nèi)容進(jìn)行分類，對(duì)299名吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管員和55名衛(wèi)生計(jì)生監(jiān)督協(xié)管信息員進(jìn)行差異性分析。對(duì)問(wèn)卷中吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)工作人員所反應(yīng)的問(wèn)題導(dǎo)入Nvivo11.0進(jìn)行編碼和歸類，采用主題分析法進(jìn)行進(jìn)一步分析?！?〕吉林省當(dāng)前已有995家社區(qū)衛(wèi)生服務(wù)中心和鄉(xiāng)鎮(zhèn)衛(wèi)生院承當(dāng)衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)工作，并全部設(shè)置了衛(wèi)生計(jì)生監(jiān)督協(xié)管室(辦)，但各地區(qū)之間承當(dāng)衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)的基層醫(yī)療衛(wèi)生機(jī)構(gòu)的服務(wù)面積和服務(wù)人口數(shù)相差較大。〔2〕吉林省應(yīng)聘衛(wèi)生計(jì)生監(jiān)督協(xié)管員1990人，實(shí)聘2050人，共計(jì)10758名工作人員，基本知足國(guó)家要求。但協(xié)管員與信息員之間在專業(yè)、年齡和兼職情況等方面具有較大差異?！?〕在基層工作人員所反應(yīng)的問(wèn)題中，管理層面和人力資源方面被反應(yīng)的次數(shù)較多，華而不實(shí)各單位不配合、兼職情況嚴(yán)重、人員缺乏是被反應(yīng)最多的問(wèn)題?！?〕在工作指標(biāo)方面，吉林省在飲用水衛(wèi)生安全巡查次數(shù)、非法行醫(yī)和非法采供血巡查次數(shù)、計(jì)劃生育相關(guān)信息實(shí)地巡查次數(shù)等方面表現(xiàn)較好，但仍有部分地區(qū)未完成全部指標(biāo)。各地區(qū)共發(fā)現(xiàn)事件或線索719件，報(bào)告事件或線索次數(shù)719件，信息報(bào)告率均為100%?！?〕提高工作人員對(duì)衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)的認(rèn)識(shí)和重視程度，拓展基層工作人員的晉升機(jī)制，適當(dāng)增加物質(zhì)和人力的投入，加強(qiáng)與衛(wèi)生監(jiān)督機(jī)構(gòu)的聯(lián)動(dòng)，提高巡查力度?！?〕加強(qiáng)物質(zhì)保障和信息化建設(shè)，減少基層工作人員的實(shí)際工作量，提高工作積極性和工作效率?！?〕加強(qiáng)人才隊(duì)伍建設(shè)，對(duì)已有的工作人員加強(qiáng)培訓(xùn)，提高業(yè)務(wù)能力；同時(shí)吸收新鮮血液，吸引本科及以上學(xué)歷的醫(yī)學(xué)生投身基層，根據(jù)各地區(qū)地理面積和人口數(shù)等原因合理配置工作人員?！?〕加強(qiáng)衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)宣傳工作，將基本公共衛(wèi)生服務(wù)的理念和重要性廣而告之，提升居民認(rèn)同感、認(rèn)可度?！?〕提高工作實(shí)效性，適當(dāng)減少文字材料的工作量，將工作重心轉(zhuǎn)移至巡查工作當(dāng)中?！?〕衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)體系基本構(gòu)成，全省開(kāi)展衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)的995家社區(qū)衛(wèi)生服務(wù)中心和鄉(xiāng)鎮(zhèn)衛(wèi)生院全部設(shè)立了衛(wèi)生計(jì)生監(jiān)督協(xié)管室〔辦〕?！?〕基層人力資源較為緊張。兼職情況嚴(yán)重，人員配置不夠合理，部分地區(qū)協(xié)管員數(shù)量未達(dá)標(biāo)；信息員相比于協(xié)管員專業(yè)化水平低、年齡偏大?！?〕宣傳工作不到位，群眾無(wú)法較好的配合衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)工作開(kāi)展?！?〕管理方式不完善，部分制度不全面，居民配合度低，巡查力度有限?！?〕硬件設(shè)備配備不完善，缺乏統(tǒng)一制服、工作證件交通工具?！?〕工作實(shí)效性缺乏，部分地區(qū)巡查次數(shù)未知足規(guī)范要求。〔7〕總體上，吉林省衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)已按國(guó)家要求穩(wěn)步開(kāi)展，主要指標(biāo)基本知足國(guó)家要求，但詳細(xì)工作的管理方式和實(shí)效性還有待提高。本文關(guān)鍵詞語(yǔ)：衛(wèi)生計(jì)生監(jiān)督協(xié)管服務(wù)；體系建設(shè)；現(xiàn)在狀況；評(píng)價(jià)AbstractObjective:Themainpurposeofthisstudywastofigureouttheestablishmentofinstitutions,staffing,trainingandthecompletionofmainindicatorsofhealthandfamilyplanningsupervisionandcomanagementservicesinJilinProvince,tounderstandthedifficultiesandproblemsencounteredbygrass-rootsworkers,toanalyzetheoverallsituationofhealthandfamilyplanningsupervisionandcomanagementservicesprovidedbyJilinProvince,andtoexploresolutionstotheexistingproblems,soastoprovidebasisforimprovingthequalityofhealthandfamilyplanningsupervisionandcomanagementservices.Methods:Inthisstudy,wecollectedthebasicinformationofthehealthandfamilyplanningsupervisionandmanagementservicesreportedbythehealthsupervisioninstitutesinJilinProvince,andinvestigatedthembysendingoutthebasicinformationquestionnairetothehealthandfamilyplanningsupervisionandmanagementservicestaff.Descriptiveanalysiswasusedtoanalyzetheestablishmentofinstitutions,basicinformationofpersonnel,trainingandthecompletionofmaintaskindicatorsofhealthandfamilyplanningsupervisionandcomanagementservicesinJilinProvince.Thecontentsof354questionnaireswereclassified,299healthandfamilyplanningsupervisionassistantsand55healthandfamilyplanningsupervisionassistantswereanalyzed.ThequestionsfedbackbythestaffwerecodedandclassifiedintoNvivo11.0,andfurtheranalyzedbytopicanalysis.Results:(1)Atpresent,thereare995communityhealthservicecentersandtownshiphealthcentersinJilinProvincetoundertaketheworkofhealthandfamilyplanningsupervisionandcomanagement,andallofthemhavesetuphealthandfamilyplanningsupervisionandcomanagementoffices,buttheserviceareaandthenumberofservicepopulationofgrass-rootsmedicalandhealthinstitutionsthatundertaketheserviceofhealthandfamilyplanningsupervisionandcomanagementvarygreatlyamongregions.(2)JilinProvinceappliedfor1990assistantsforhealthandfamilyplanningsupervisionand2050actualemployees,atotalof10758staff,basicallymeetingthenationalrequirements.However,therearegreatdifferencesintheprofessional,ageandpart-timesituationbetweentheassistantmanagersandtheinformationworkers.(3)Amongtheproblemsfedbackbythegrass-rootsstaff,themanagementlevelandhumanresourceswerefedbackmorefrequently,amongwhichthemostproblemswerethenoncooperationofeachunit,seriouspart-timesituationandinsufficientstaff.(4)Intermsofworkindicators,JilinProvincehasagoodperformanceintermsofthenumberofinspectionsondrinkingwatersafety,illegalpracticeofmedicine,illegalbloodcollectionandsupply,andthenumberoffieldinspectionsonfamilyplanningrelatedinformation,butstillsomeareashavenotcompletedallindicators.719incidentsorclueswerefoundinallregions,and719incidentsorclueswerereported.Theinformationreportingratewas100%.Advices：(1)Improvethestaffsawarenessandattentiontothehealthandfamilyplanningsupervisionservice,expandthepromotionmechanismofgrass-rootsstaff,appropriatelyincreasetheinputofmaterialandhumanresources,strengthenthelinkagewiththehealthsupervisioninstitutions,andimprovetheinspectionintensity.(2)Strengthenmaterialsecurityandinformationconstruction,reducetheactualworkloadofgrass-rootsworkers,andimproveworkenthusiasmandefficiency.(3)Strengthentheconstructionoftalentteam,strengthenthetrainingintensityofexistingstaff,improvetheirprofessionalability;atthesametime,absorbfreshblood,attractmedicalstudentswithbachelorsdegreeorabovetojointhegrass-rootslevel,andreasonablyallocatestaffaccordingtothegeographicalareaandpopulationofeachregion.(4)Strengthenthepublicityofhealthandfamilyplanningsupervisionandmanagementservices,publicizetheconceptandimportanceofbasicpublichealthservices,andenhanceresidentssenseofidentityandrecognition.〔5〕Improvetheeffectivenessofthework,appropriatelyreducetheworkloadoftextmaterials,andshiftthefocusofworktopatrolwork.Conclusion:〔1〕Thehealthandfamilyplanningsupervisionandcomanagementservicesystemhasbeenbasicallyformed.995communityhealthservicecentersandtownshiphealthcentersthatcarryoutthehealthandfamilyplanningsupervisionandcomanagementservicehavesetupthehealthandfamilyplanningsupervisionandcoManagementOffice.〔2〕Grassrootshumanresourcesarerelativelytense.Thesituationofpart-timejobisserious,thestaffingisnotreasonable,andthenumberofassistantmanagersinsomeareasisnotuptothestandard;comparedwiththeassistantmanagers,thelevelofspecializationofinformationworkersislowandtheageistoolarge.〔3〕Thepublicityworkisnotinplace,andthemassesareunabletobettercooperatewiththehealthandfamilyplanningsupervisionandcomanagementservice.〔4〕Themanagementmodeisnotperfect,somesystemsarenotcomprehensive,thecooperationdegreeofresidentsisquitelow,andtheinspectionintensityislimited.〔5〕Thehardwareequipmentisnotperfect,andthereisalackofuniformandworkpermittransportation.〔6〕Theeffectivenessoftheworkisinsufficient,andthenumberofinspectionsinsomeareasdoesnotmeettherequirementsofthespecification.〔7〕Insummary,JilinProvincehealthandfamilyplanningsupervisioncomanagementservicehasbeencarriedoutsteadilyaccording