CAJ | 학술논문

目的：探索广东省社区医疗机构卫生应急相关科室设置和制度建设现状，为今后开展基层卫生应急管理提供科学依据。方法于2013年3-9月，采用分层随机抽样的方法在广东省21个地市抽取220家社区医疗机构（珠三角地区抽取110家，粤东粤西抽取80家，粤北地区抽取30家社区医疗机构）开展调查，调查内容包括卫生应急人力资源、科室设置和卫生应急制度情况。结果被调查的社区医疗机构中，每万居民拥有临床医生、护士和公卫医师数分别为（5.1±4.4）、（5.1±4.8）、（1.4±1.8）人，有193家（87.7%）社区医疗机构设置了传染病报告专职人员；设置应急指挥部门、应急处理小组、发热门诊和预检分诊处的社区医疗机构分别为135家（61.4%）、162家（73.6%）、209家（95.0%）和128家（58.2%）；有195家（88.6%）社区医疗机构建立了应急管理制度，194家（88.2%）与上级部门建立了协作沟通机制；有174家（79.1%）社区医疗机构建立了卫生应急综合预案，其中专项预案的建立率排在前四位的是传染病疫情预案（93.6%）、食源性疾病爆发预案（62.7%）、医院性感染爆发预案（51.8%）和新发传染病/群体性不明原因传染病预案（50.9%），其中珠三角社区医疗机构的卫生应急科室设置和制度建设优于其他地区（P﹤0.05）。结论广东省社区医疗机构卫生应急相关科室设置及制度建设现状存在不足，应加强基层医疗机构卫生应急软硬件的建设，提高基层卫生应急水平。
목적：탐색광동성사구의료궤구위생응급상관과실설치화제도건설현상，위금후개전기층위생응급관리제공과학의거。방법우2013년3-9월，채용분층수궤추양적방법재광동성21개지시추취220가사구의료궤구（주삼각지구추취110가，월동월서추취80가，월북지구추취30가사구의료궤구）개전조사，조사내용포괄위생응급인력자원、과실설치화위생응급제도정황。결과피조사적사구의료궤구중，매만거민옹유림상의생、호사화공위의사수분별위（5.1±4.4）、（5.1±4.8）、（1.4±1.8）인，유193가（87.7%）사구의료궤구설치료전염병보고전직인원；설치응급지휘부문、응급처리소조、발열문진화예검분진처적사구의료궤구분별위135가（61.4%）、162가（73.6%）、209가（95.0%）화128가（58.2%）；유195가（88.6%）사구의료궤구건립료응급관리제도，194가（88.2%）여상급부문건립료협작구통궤제；유174가（79.1%）사구의료궤구건립료위생응급종합예안，기중전항예안적건립솔배재전사위적시전염병역정예안（93.6%）、식원성질병폭발예안（62.7%）、의원성감염폭발예안（51.8%）화신발전염병/군체성불명원인전염병예안（50.9%），기중주삼각사구의료궤구적위생응급과실설치화제도건설우우기타지구（P﹤0.05）。결론광동성사구의료궤구위생응급상관과실설치급제도건설현상존재불족，응가강기층의료궤구위생응급연경건적건설，제고기층위생응급수평。
Objective To explore the status of related community health emergency institutional settings and system construction of community hospitals in Guangdong province and provide scientific basis for future health emergency management at basic level. Methods Between March and September 2013 ,220 community medical organizations were selected from 21 city-regions in Guangdong province(110 from Pearl River Delta Area,80 from east Guangdong and west Guangdong,30 from north Guangdong)by using stratified random sampling method and were investigated about health emergency human resources,depart-ment installment and health emergency system. Results In the community health institutions under investigated,the numbers of clinic doctors,nurses and public doctors per million community residents owned were ( 5. 1 ± 4. 4 ), ( 5. 1 ± 4. 8 ), ( 1. 4 ±1. 8)respectively. 193(87. 7%)were equipped special staff who reported cases of inflection diseases. 135(61. 4%),162 (73. 6%),209(95. 0%)and 128(58. 2%)community medical organizations were equipped emergency departments,emer-gency handling team,fever clinic and triage respectively. 195(88. 6%)established the health emergency management systems, 194(88. 2%)established cooperative communication mechanism and 174(79. 1%)established health emergency preparedness plans,among which the first four were epidemic situation of infectious diseases plan(93. 6%),foodborne disease outbreaks plan(62. 7%)Hospital infection outbreaks plan(51. 8%),new infectious diseases/unexplained infectious diseases with group character plan(50. 9%). The community health emergency related institutional settings and system construction of community hospitals in the Pearl River Delta region were better than that in other regions in Guangdong ( P ﹤0. 05 ) . Conclusion The community health emergency related institutional settings and systems of community medical organizations in Guangdong province have some deficiencies. We need to strength the construction of the emergency software and hardware to increase the emergency re-sponse capability at basic level.