Page 87 - 中国全科医学2022-16期

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Corresponding author：WU Yingmin，Associate professor，Master supervisor；E-mail：13880544028@163.com
【Abstract】 Background The rapid development of informatization in primary care in regions inhabited by ethnic
minorities during the 13th Five-Year Plan period（2016—2020），has laid a foundation for the improvement of the serving capacity
of primary care supported by information technologies，but there is a lack of research on information technology and the efficiency of
primary care. Objective To assess the status including effectiveness of informatization in primary care in China asregions inhabited
by ethnic minorities，to explore the impact of information technology on improving the efficiency of primary care. Methods From
July to October 2020，84 primary care institutions in 23 ethnic counties in three autonomous prefectures of Sichuan（Ganzi，
Liangshan and Aba） were selected by stratified sampling，and whose directors were invited to complete a self-administered
questionnaire survey for understanding the status including effectiveness of informatization in their institutions. Furthermore，the
heads of local health committees and directors of primary care institutions in these ethnic counties were invited to attend a group
discussion regardingthe setting of departments，service development，status of informatization and settings for information services
in primary care institutions. Results In terms of software construction，of the 84 primary care institutions，57（67.9%） used the
public health system，44（52.4%） used the family doctor management system，and 25（29.8%） use the hospital information
system. Forty-seven（56.0%）primary care institutions had achieved vertical connectivity with other institutions（mostly regional-
and county-level institutions as well as other members in a regional medical consortium） using information technologies，
and regional informatization. Institutions that had horizontal connectivity with 69（74.4%）of the primary care institutions were
medical insurance departments. Only 18（21.4%） institutions had independent information departments，and 34（41.0%）did
not employ information professionals. Lack of information professionals〔64（76.2%）〕，insufficient funds〔52（61.9%）〕
and weak infrastructure〔51（60.7%）〕 were main problems revealed in informatization construction. Institutions with regional
informatization，vertical connectivity with other institutions，and the construction of a hospital information platform with electronic
medical record system as the core were superior to those without in terms of setting of laboratory and examination departments and
provision of traditional Chinese medicine services（P<0.05）. According to the group discussion，the institutions had basically
completed the construction of information standardization，with well-equipped hardware facilities，health informatization-
derived management efficiencies，such as improved efficiency，increased scope of supervision，refined supervision，scientific
decision-making and digital governance，and service potencies，such as increased efficiency，accessibility and quality of services.
Conclusion Information technology could greatly contribute to the solving of bottleneck during services delivery in primary care
in regions inhabited by ethnic minorities，which has promoted the setting of departments and service extension，and improved the
accessibility of health services，as well as the innovation in service delivery modes in these institutions. Problems identified in the
informatization construction include insufficient investment in informatization operation and maintenance，insufficient application and
lack of information professionals. In view of this，it is suggested to strengthen the investment in informatization construction in primary
care，establish a standardized and applicable health informatization training mechanism，pay attention to the construction of a health
information talent team，and deepen the intelligent application of information technology in primary care services.
【Key words】 Primary health care institutions；Hospital information systems；Information efficiency；Ethnic areas

加强基层卫生信息化建设，是新医改“保基本、强 建设不全，信息化程度远低于非民族地区，基层医疗卫
基层、建机制”的重要技术支撑 ［1］ ，对于提升基层医疗 生机构信息化水平远滞后于县级及以上综合医院 ［2-3］ 。
卫生机构服务能力、提高医疗卫生管理水平、合理配置 关于卫生信息化的研究多集中在内地县级及以上综合医
医疗资源等具有重要作用。我国高度重视基层卫生信息 院，以单案例和描述性统计分析入手，分析信息化建设
化建设，2009 年将其作为新医改的“四梁八柱”之一； 现状、存在问题及建设成效，缺乏推广普适性及对民族
“十二五”期间为建设实用、共享的医疗卫生信息系统， 地区基层医疗卫生机构的关注。基于此，本文以民族地
加大了对基层卫生信息化的投入；“十三五”信息化发 区基层医疗卫生机构为研究对象，了解其卫生信息化建
展规划提出要促进人口健康信息互通共享，提升健康信 设现状，并初步探讨信息化对卫生服务效能的影响，弥
息服务能力。随着云计算、大数据、人工智能等新技术 补民族地区基层卫生信息化研究不足，为民族地区基层
的发展，我国基层卫生信息化取得了进一步成效，软 / 硬 医疗卫生机构在“十四五”期间进行信息化建设及通过
件水平得到大幅提升，在为基层医疗卫生机构减负、增效、 信息技术助推服务、管理效能提升提供参考建议。
提质、赋能等方面起到积极效用。然而从已有研究来看， 1 对象与方法
我国卫生信息化发展不均问题明显，民族地区卫生信息 1.1 研究对象 2020 年 7—10 月，根据地理区位及卫
化的技术和管理理念落后、人才缺乏、投入不足，硬件 生水平，采用分层抽样的方法选取四川甘孜、凉山、阿