Abstract: Background　The informatization of public health is a key measure to improve the accessibility of public health services，and the development of essential public health services provided by primary care，the gatekeeper of residents' health. Objective　To investigate the informatization of public health in primary care in Sichuan，and analyze the existing problems，providing evidence for promoting public health informatization in primary care. Methods　From November to December 2019，an online questionnaire survey was conducted with the deans responsible for healthcare of 1 022 primary medical institutions randomly selected from each district and county at the same ratio in Sichuan Province to collect information mainly about the use of public health information system，including funds，infrastructure，and human resources regarding the use of system，the system coverage，and obstacles to the use of the system. Results　A total of 1 133 cases attended the survey，994 of them responded effectively，achieving a response rate of 87.7%. Among the surveyed institutions，each used nine public health systems on average；48.6%（483/994）had special funds for the informatization development of public health，91.0%（905/994） had sufficient hardware equipment to meet the work needs，45.0%（447/994）had at least five workers to fill in and report health information. The difference in the prevalence of using the PCMIS between community health centers and township health centers 〔82.9%（68/82）vs 96.3%（878/912）〕 was statistical significant（P<0.05）. Among the workers responsible for filling in and reporting health information in the survey institutions，37.7%（n=357） majored in clinical medicine，30.4% majored in nursing（n=288），and only 2.2% majored in information technology（n=21）. The PCMIS was thought to be enough to support the in-hospital needs in 63.2%（43/82） of community health centers and 74.7%（656/912） of township health centers，with statistical difference（P<0.05）. Repeated filling in the public health module of the PCMIS for reporting the information was found in each institution. For the obstacles to the use of public health module，"the insufficiency of the software"〔36.8%（25/68）〕 was chosen as the primary one in the community health centers，but for the township health centers，"the lack of professionals"〔31.4%（276/879）〕 was chosen. Conclusion　Many problems have been found in the public health informatization in primary care in Sichuan Province，such as insufficient basic support，inefficiency of system development，lopsided development between different areas and different types of health institutions，and the insufficiency of the software，which need to be improved urgently.

Key words: Primary medical institution, Modernization of information technology, Township health centers, Community health centers, Information system

摘要： 背景　基层医疗卫生机构是居民健康的“守门人”，其公共卫生服务能够提升医疗卫生服务的可及性，信息化建设则是促进基层公共卫生服务发展的重要措施。目的　了解四川省基层医疗卫生机构公共卫生信息化建设现状和存在问题，为推动基层公共卫生信息化建设提供参考。方法　以四川省所有市、县（区）为单位，采用等比例单纯随机法抽取基层医疗卫生机构1 022个，于2019年11—12月，采用网络问卷法对医院业务院长进行调查。内容主要为公共卫生业务管理信息系统、“基层医疗卫生机构管理信息系统”（简称基层系统）两类系统使用情况，包括经费、基础设施、覆盖率、人员、阻碍因素等。本次调查共回收问卷1 133份，有效问卷994份，有效率为87.7%。结果　调查机构中，平均使用9个公共卫生业务管理信息系统；48.6%（483/994）的机构有专门信息化建设经费；91.0%（905/994）的硬件设备满足工作需求；45.0%（447/994）的机构信息填报人员在5人及以上；社区卫生服务中心和乡镇卫生院在经费、硬件设备、人员配置方面比较，差异有统计学意义（P<0.05）。82.9%（68/82）社区卫生服务中心、96.3%（878/912）乡镇卫生院使用了基层系统，两者差异有统计学意义（P<0.05）。填报人员专业以临床（357人，占37.7%）、护士/护理（288人，占30.4%）为主，信息技术专业少见（21人，占2.2%）；63.2%（43/82）的社区卫生服务中心和74.7%（656/912）的乡镇卫生院认为基层系统满足院内业务需求，两者差异有统计学意义（P<0.05）。基层系统公共卫生服务功能模块信息均存在重复填报问题。阻碍公共卫生模块使用的因素分析，社区卫生服务中心首选“软件功能不完善”〔36.8%（25/68）〕，乡镇卫生院首选“专业人才匮乏”〔31.4%（276/879）〕。结论　基层医疗卫生机构公共卫生信息化存在基础保障薄弱、系统建设效率低、不同地区和不同类型机构发展不平衡、系统软件功能还不完善等问题，亟须进一步改进。

关键词: 基层医疗卫生机构, 信息化, 乡镇卫生院, 社区卫生服务中心, 信息系统