It is understood that the national basic public health service standards mainly include 1 1, namely: urban and rural residents' health file management, health education, vaccination, health management of children aged 0-6, maternal health management, health management of the elderly over 65, health management of patients with hypertension and type 2 diabetes, and health management of patients with severe mental illness, infectious diseases and emergencies. In various service specifications, the service object, content, process, requirements, assessment indicators, service record forms, etc. are clearly defined.
According to director Wan Quan, all residents and patients with corresponding diseases in the county can enjoy the corresponding services free of charge, and these 1 1 services can be roughly divided into three categories, namely, universal service, key population service and key disease prevention and control service.
Serve the whole people
Management of health records of urban and rural residents. Mainly for all residents in the area to gradually establish a unified and standardized residents' health records, and update the contents of the files in time, and gradually implement computer information management, and issue residents' health information cards (our county has not yet issued them). All residents go to "public health service institutions" or "public health service institutions" for medical treatment through household surveys, disease screening and health checkups, and establish health records for residents.
Moreover, after the informatization of residents' health records is gradually implemented, residents can use the health record information card to query their health records at any time. When visiting a hospital, doctors can also retrieve health records at any time to understand the past medical history, so as to prescribe the right medicine.
Health education. Residents in the county can learn and understand basic knowledge and skills such as health literacy, prenatal and postnatal care, and healthy lifestyle development through publicity materials, audio-visual materials, billboards, health consultation, lectures, etc. issued by "public health service institutions". The purpose is to guide residents to learn, master health knowledge and necessary health skills, promote residents to develop healthy study and living habits, and ensure physical and mental health.
Services for key populations
Vaccinate. The county's "public health service institutions" set up vaccination cards for children aged 0-6 free of charge, issued children's vaccination certificates, and informed guardians of school-age children of the types, time, place and requirements of vaccination through appointments, notices and telephone calls. All children aged 0-6, including migrant children, should go to local "public health service institutions" for free vaccination with hepatitis B vaccine, BCG vaccine, polio vaccine, DTP vaccine, measles vaccine, hepatitis A vaccine, meningococcal vaccine, Japanese encephalitis vaccine and measles vaccine. According to the needs of disease control, the state and local governments can carry out emergency vaccination against hemorrhagic fever, leptospirosis and anthrax in key areas and key populations, or strengthen immunization, mass vaccination and emergency vaccination against hepatitis B, measles and polio.
Health management of children aged 0 ~ 6. The county's "public health service institutions" will set up a "health care manual for children aged 0-6", which will be published within 1 week after the newborn is discharged, and will be published at 3 years old, 6 years old, 8 years old, 12 years old, 18 years old, 24 years old, 30 years old, 36 months old and 4 years old respectively.
Maternal health management. The county's "public health service institutions" set up the "Handbook of Maternal Health Care" for pregnant women free of charge, and provided free pregnancy care services at least five times in 12 weeks, 16 ~ 20 weeks, 2 1 ~ 24 weeks, 28 ~ 36 weeks and 37 ~ 40 weeks respectively. Health management during pregnancy mainly includes routine physical examination and detection, evaluation of the growth and development of pregnant women and fetus, high-risk screening and prenatal health guidance. Postpartum visit includes physical examination, postpartum disease prevention and health guidance, maternal physical recovery assessment and neonatal growth assessment and guidance.
Health management of the elderly. The county's "public health service institutions" provide 1 health management services for the elderly over 65 years old every year, including lifestyle and health status assessment, physical examination, auxiliary examination, health guidance, etc. Elderly people diagnosed with hypertension and diabetes in management were transferred to chronic disease management.
Health management of patients with chronic diseases. It mainly includes the health management of patients with hypertension and type 2 diabetes.
Health management of patients with hypertension. "Public health service institutions" measure the blood pressure of residents over 35 for the first time every year. Anyone who meets the diagnostic criteria for hypertension is diagnosed as hypertension, and the "public health service institution" provides the health records of patients with hypertension free of charge, and provides 4 face-to-face health follow-up visits and/kloc-0 health checkups every year. During the health follow-up, measure blood pressure and evaluate whether there is an emergency, whether it is necessary to transfer to a higher hospital for treatment, understand the patient's medication and lifestyle, judge the effect of blood pressure control, and conduct medication guidance and classified intervention. Physical examination is mainly routine physical examination.
Health management of patients with type 2 diabetes. "Public health service institutions" establish health records for patients with type 2 diabetes free of charge, and provide four face-to-face follow-up visits every year, including four fasting blood glucose tests and/kloc-0 health checkups. During face-to-face follow-up, we must measure fasting blood glucose and blood pressure, evaluate whether there is a critical situation, whether it is necessary to transfer to hospital for treatment, check the pulse of dorsal artery of foot, understand the medication situation and lifestyle of patients, determine the effect of blood glucose control, and carry out medication guidance and classified intervention. Physical examination is mainly routine physical examination.
Management of patients with severe mental illness. "Public health service institutions" establish patient information files for patients with severe mental illness who have been diagnosed clearly and live at home for free, and make at least four follow-up visits every year, with physical examination 1 time. Every follow-up should be conducted with risk assessment, mental state examination, medication guidance and classified intervention. Physical examination should be carried out after the patient's condition permits and the family members agree, and can be carried out under the guidance of professional institutions, including general physical examination, blood pressure, weight, blood routine (including white blood cell classification), transaminase, blood sugar and electrocardiogram.
Health management of traditional Chinese medicine. This service was added on 20 13, mainly to establish the health records of Chinese medicine services for the elderly over 65 years old and children aged 0-36 months for free, and to provide Chinese medicine health care guidance.
Key disease prevention and control services
Reporting and handling of infectious diseases and public health emergencies. "Public health service institutions" should promptly discover, register and report infectious diseases, suspected cases and public health emergencies found within their jurisdiction, and participate in the on-site epidemic treatment; Carry out knowledge and consulting services on the prevention and treatment of infectious diseases; Cooperate with professional public health institutions to treat and manage non-hospitalized tuberculosis patients and AIDS patients.
Health supervision and coordination services. "Public * * * health service institutions" timely discover and report food poisoning and other incidents and assist in the investigation, and carry out occupational health consultation and guidance, drinking water hygiene and safety inspection, school health service and illegal medical practice and illegal confession information report.
Through nearly five years' efforts, the basic public health service project has achieved certain results in our county, with the county coverage rate reaching 100% and the people's benefit rate reaching 90%. The incidence of Class B infectious diseases is controlled between 3 million and 65438+10,000, and there are no public health emergencies such as major infectious diseases and food poisoning. Moreover, the infant mortality rate dropped to 7.05‰, the birth defect rate dropped to 4. 18‰, and the maternal mortality rate dropped to 24.34/65438+ 10,000. The number of hypertension and diabetes managers reached 22,456 and 5,030 respectively.
"So far, the promotion of public health service projects has effectively managed the overall health status of residents in our county and improved the health index of residents in the county." Fu Yong, director of the county health bureau, said that according to the analysis of statistical data in the past five years, the incidence of infectious diseases and maternal mortality in our county have been declining, and the management of chronic diseases in the elderly has also become standardized. By the beginning of this year, the coverage rate of basic public health services in the county reached 100%, and the benefit rate of the masses reached 90%. The incidence of Class B infectious diseases is controlled between 3 million and 65438+10,000, and there are no public health emergencies such as major infectious diseases and food poisoning. Moreover, the infant mortality rate dropped to 7.05‰, the birth defect rate dropped to 4. 18‰, and the maternal mortality rate dropped to 24.34/65438+ 10,000. The number of hypertension and diabetes managers reached 22,456 and 5,030 respectively.
The deepening of eleven basic public health service projects can not be separated from the efforts of grassroots medical staff, and all the people benefit from it. The government increases investment every year to improve people's health defense line through equalization of basic public health services.