上海市杨浦区全科临床质量控制考核结果分析

  目的  了解上海市杨浦区全科临床质量控制考核情况, 夯实全科医生队伍及人才建设, 提升全科医生临床能力, 提高全科医疗服务。  方法  收集2017年11月-2019年11月杨浦区全科临床质量控制小组对12家社区卫生服务中心的考核资料进行回顾性分析, 包括全科临床思维、SOAP病史书写、常规技能操作、心电图读图诊断、X线诊断、常见慢性病管理能力, 研究全科医生配置、全科医生临床能力及全科科研能力等情况。  结果  3年内全区每万人口全科医生配置分别为3.34名、3.36名和3.32名; 其中, 中级以上职称占全科医生比例分别为83.12%、88.70%、93.21%;心电图读图诊断能力从5.60分上升至7.67分(标准分为10分); 慢性病管理能力考核得分分别为9.71分、9.90分、10.25分(标准分为15分); 全科科研能力方面, 12家社区卫生服务中心承担市级课题15项、区级课题21项、院校级课题11项, 护理区级课题2项, 康复市级、区级课题各2项, 公共卫生区级课题1项, 其中有2家社区3年内无课题立项。全区每年论文发表数量为50篇左右, 核心期刊比例不足30%。  结论  全科医生数量相对不足, 临床能力、全科科研能力相对薄弱, 需要进一步努力完善和落实各项全科临床质量控制考核管理制度及相关标准, 积极探索优秀全科医学人才队伍建设和培养, 提高全科医疗水平及科研能力, 担负起居民健康"守门人"的职责。 

Analysis of assessment results of general practice clinical quality control in Yangpu District,Shanghai

  Objective  To understand the assessment results of general practice clinical quality control in Yangpu District, Shanghai, consolidate the team of general practitioners and talent construction, improve the clinical ability of general practitioners, enhance general medical services.  Methods  The assessment data of 12 community health service centers in Yangpu District from November 2017 to November 2019 were collected, including general practice clinical thinking, SOAP (Subjective Objective Assessment Plan) medical history writing, routine skill operation, electrocardiogram reading diagnosis, X-ray diagnosis, common chronic disease management capabilities, the configuration of general practitioners, clinical capabilities of general practitioners, and general medical research capabilities.  Results  The number of general practitioners per 10 000 population in the district was 3.34, 3.36, and 3.32 in the three years.Among them, the proportion of general practitioners with intermediate titles and above was 83.12%, 88.70%, and 93.21%, respectively.The electrocardiogram reading and diagnosis ability score was 5.60 rose to 7.67(standard score of 10).Chronic disease management ability assessment scores were 9.71, 9.90, and 10.25(standard score of 15), respectively.In terms of general scientific research capabilities: 12 community health service centers undertook 15 municipal-level projects, 21 district-level projects, 11 college-level projects, 2 nursing district-level projects, 2 city-level and district-level projects for rehabilitation, 1 district-level public health projects, and 2 of them had no community-level projects within 3 years.About 50 papers were published each year, and the proportion of the core information science periodicals was less than 30%.  Conclusion  The number of general practitioners is relatively insufficient, and the clinical capabilities and general practice research capabilities are relatively weak.It is necessary to further improve and implement various general practice clinical quality control assessment and management systems and related standards, actively explore the construction and training of excellent general practice talents, improve the level of general medical care and scientific research capabilities, and assume the responsibility of the"gatekeeper"of residents'health.