Pudong New Area Community Health Center Out-patient Clinical Issues

1 Establish the basis and purpose of research questionWith the development of health care reform, "people-oriented" management concept and service concept gradually established in the process, doctors workload issues more and more attention. While patient satisfaction is the evaluation of medical service quality an important indicator, which reflects the subjective experience of medical treatment, while patient satisfaction and other medical services are also indicators of production closely. In recent years, the community to "see" the grumbling more and more, much on the one hand because the clinic during the time waiting in line too long. In this study, data from the clinic perspective of community out-patient medical treatment on the status of the sample analysis, answer the current popular "community health center positioning," "How can the role of community hospitals, convenience function?"... ...And so on. Meanwhile, the problems found in the data for the follow-up survey of focus and clear the contents of the questionnaire should be provided through the work of thinking. The region's community health development, health service centers to provide policy recommendations to adjust.2 Materials and Methods1 SourceIn this study samples from the Pudong New District 5 community:Shanggang, Weifang, Huamu, GaoDong, Zhangjiang health service center in 2008 clinics data. Use of all community health centers in the raw data by the Community Health Center and the District Health Board Information Services Department. Community Health Center provides a database of the community health service centers were full year of 2008 Community Health Center patient database in the HIS. Selected indicators are:out-patient card number, serial number, age, medical insurance, registration date, registration time, or out-patient specialist, registered department code, doctor code, the patient eventually paid time.2 analysisIn this study, the data analysis process were completed in SAS9.1.3, analysis mainly descriptive statistical methods (such as mean, percentage, etc.). 3 the main findings(A) community health service center of the main target of out-patientOf various levels of community health service centers and community health service centers to serve mainly the situation. Pudong New Area Community Health Center patients Bacheng over the age of more than 40 patients,66 years old accounted for 41.8% of patients. Community health service centers to see a doctor for 85.2% of patients had health insurance. Which serve mainly the elderly to have health insurance.(B) community health service centers of patient flowThis part of the analysis of patient flow through the month, week, day of the distribution of the workload of community health service center about the minimum and maximum time distribution.:Maximum flow and Emergency Department in March, reaching 27.1 million times, to 1.24 times the average in other months; in April at least, the number 19.7 million for 0.87 times the average in other months; community health service center outpatient flow shows the state of imbalance.(C) the workload of doctorsIn the Pudong New Area, relative to the overall out-patient services people need, the doctors work out the average load is not high. Most of the month, the community health service center doctors an average of 8-10 per half-day patients. The reason why a doctor will feel the high workload, the patients complain about medical treatment is difficult, a key reason for the patient to the community health service centers uneven distribution of the time, there is aggregation. This clustering: of the month on a first in the gathering. In 2008, the community health service center in March of outpatient workload has reached an average of admissions per half day 10.4. Second, this aggregation of performance in the week focused on attendance of the gathering on Monday. Pudong New Area, which led to the existence of community health service centers more obvious case of doctors out of work overload.(D) the repeated visits of the patientCommunity health service center have a considerable number of patients for the chronic cases of patients who go to community health service center is actually simple to talk about the recent situation, and then retrieve it as the same can be concluded. Patients seek repeated visits in the community health service centers, most outstanding. Repeated visits of the patients,76.5% of patients over the age of the patients was 40 people,65 of these patients reached 34.3%. Many patients seek treatment for more than the weight of the patient health insurance coverage Bacheng crowd; about two-thirds of patients were non-working population. And this part of the main sections of patients seek treatment for the medical, small, surgery, gynecology, etc.(E) the patient see a doctor to spend time to studySample from a comprehensive community health service center situation, the patient see a doctor to spend time was 28.0 minutes, significantly longer. If the sub-age perspective, community health service centers in the elderly doctor takes the longest (an average of 31.3 minutes), children spent the least time (an average of 16.3 minutes). Doctor from the patient to spend time on, long time to explaining the community health service centers are less efficient out-patient medical admissions, which directly resulted in the follow-up of patients waiting too long4 the study's main exploration(A) enhancing the training of general practitioners, a family doctor systemDoctor is not rational, over-specialized team of doctors, and educated, well-trained general practitioners a serious lack, combined with the impact of various factors, makes the community health service can not carry out fully and effectively together in China. General Practitioners are general medical and major actors. Can solve the vast majority of health problems, then train a large number of qualified management by general practitioners should be human development and construction of Health and direction of the mainstream, is a health team building in the long term, the urgent need of our health service system of high-quality General Practitioners; Pudong New Area, the current community health service centers there are different sections clinic doctors working load is not balanced, the efficiency of different patient characteristics of waiting time is not balanced. Strengthening the training of general practitioners, established a family doctor system, community health service center for doctors to reduce the workload and reduce patient waiting time has an important role.(B) the establishment of the patient appointment system visitsThe care of patients booking system can reduce waiting time and increase the hospital's reputation; the same time, for the center of Pudong, the characteristics of community health services, many of the patients for elderly patients, they go to community health service centers mainly for chronic daily take drugs. If combined with the family doctor system, doctors in charge of a region for each patient, allowed the region to understand the basic situation of patients. Through the appointment system, the formation of a fixed admissions doctors and patients, patient relations, so doctors know the patients condition, past medical history, contraindications, drug habits and other information, you can greatly save time, increase efficiency, improve medical quality and shorten the follow-up waiting time.