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The author:(作者)aaapublished in(发表于) 2014/7/16 9:12:21 Guangzhou more than a community hospital health fraud
Doctors for tens of thousands of residents was too much to do
Unable to complete the task to deduct wages, each built a Government-subsidized hospitals 40
Overall: new bulletin reporter Chen Qi Tian
Interview: new bulletin reporter Li Qiuling's Huang sui
Express News, you know that there are "personal health record" do such thing?
Personal health record is an important waste management engineer after the new health care reform, is used to record each person from birth to death of all the changes in vital signs, health and so on. Guangzhou financial appropriations for this purpose, 40 Yuan to help each resident's "health record service pack." The money, allocated to local community hospitals, used to establish community health records, free medical examinations and other public services.
Recently, the new Express Reporter received a tip of a community hospital, saying their jurisdictions over more than 40,000 health records, more than half are false--because only doctors community hospital, couldn't finish the investigation up to tens of thousands of people within the community; and if they don't meet the mission, the doctor is to be deducted monthly wage. Thus, doctors can only be "forced to fake file" ... ...
Express Reporter of one to many community hospitals such as yuexiu, Lai Wan, Tianhe verified discovery health phenomena are not true, still prevalent, and many residents really, because the information cannot be updated, track, eventually became a "dead document." Many community physicians complained bitterly: "health records has become a community doctor's heavy workload. Understaffed, overwhelmed. "
In response, the City Health Department responded yesterday, community physicians will be adjusted according to the actual situation of residents file workload, increase the electronic filing process. While provincial health planning Committee Director Liao Xinbo proposes, health records should be a person medical history, medication history, inspection history, medical history and other information accumulated, in order to achieve this aim, health records must be underpinned by real information, and on this basis to make health records have a preventive and guidance role.
Community medical practitioner
Without the knowledge of residents filed in response to check
"More than 40,000 copies of health records, more than half of fraud. "Yesterday, the head of a community hospital, Zhang (not his real name) is revealed to reporters, more than 40,000 copies of paper records, stuffed with more than 10 square meters archive, so as to cope while there check out. Usually is a "dead document."
Some residents don't know they're being filed
New Flash: your health record is the real one?
Director: certainly can't say absolutely real, and some come to us sick, we will get the information to fill in. Chronic disease populations within their respective jurisdictions, over 65 years old, 0-6-year-olds and the perinatal health of women of childbearing age are mostly true. These people cannot be said to be fake, can only be described as copy, to copy their information on my health records. In fact, we don't want to do it.
New Flash: that number is fake?
Director: like our community hospitals now have built more than 40,000 copies, more than half (false). We also had to go to other communities, everyone is such a situation. They also honestly say: "went to the police station, the street (residence) data and copied it. "Community hospitals now for health records, has tried every way to get population information. We also use some very old information.
New Flash: fraud that some residents don't know?
Director: Yes, I do not know.
New Flash: residents ' complaints to know what to do?
Director: such information generally will not leak out. But if, as said above, established health records to dock with the regional information system of the city, residents can access to to the Internet, it will be very troublesome thing. Now don't know what to do.
New Flash: do these files have taken out?
Director: totally useless. To check above, taken out again to deal with.
Government has put residents not enjoy
New Flash: why fraud?
Director: hung up our 20% performance of the Government, all operational, clinical, and health records filing rate has a marker, the layers within the municipal, district and hospital assessment, not taken money for clearance.
New bulletin: Government subsidy of 40 Yuan per person, subsidy in place yet?
Director: subsidies are in place. But if everyone is required per cent of free public services such as medical content of the package, money was not enough.
New Flash: hospital took public money for service packs, no service?
Director: no way, sometimes ask them to free medical examination, please please do not come. Can only say that the Government invested a lot of money for public services, but not all residents are willing to enjoy, such as the physical examination is the basis.
Awkward
On-site documentation often disagreeable
"Every household survey on health situation, with 30% chance of finding one is good. "Yang Mei doctors working in a community health service stations said they nearly 60,000 area residents, but the number will be positioned at the first diagnosis of community health service center no more than 8000 people, many residents have little ill, and would rather spend more money who want to go to the hospital. In order to make health records, active-site only.
Being like a cheater, get tired, was scolded by the neighborhood ... ... Community physicians most embarrassing is that public forums on health with a look of sincere, but often encounter the watchful eyes, IU. On one occasion, Dr Yeoh said a survey of residents, this family no matter what do not believe them, also threatened: "you don't go, I'll set the dog people! ”
"We also face tremendous pressure, to persuade residents to the community to nearly every file. "According to a general practitioner, entrance door, take about 1 hour to complete a paper health records, because there is no mobile devices, you have to fill out the paper's archives, and then taken back to the hospital and then entered into the computer. A lot of work.
What is the
Personal health record?
A why files?
Document object: residents
Fill Archive Privacy involved healthy people the indifference
Miss Lee, who lives in the plum village street, yuexiu district, Guangzhou City, recently went to the community hospital, medical staff told her: "can register their work to establish health records to facilitate community practitioners focus on the health status of the residents. "Even though doctors told her, after making health records, and will regularly carry out health lecture and provided medical and dietary advice, but Miss Lee did not budge and refusing to fill out information.
Liao, Tianhe district, Ms, Ms Zhang more than more than 10 residents were told the new express press, they know the community hospital has been advocacy, promotion of health files, but not convinced. "The community has posted a notice, but I do not know what is this archive useful, so I didn't really know about it. ”
"I rarely get sick, ill go to hospitals. Even where community health service center does not know. "30 years old people Miss Chen said that many healthy, young people feel that this service is optional.
New bulletin reporter read through the health record, found that very fine content is required to fill out specific, each have a 4 page paper health records. In addition to understand residents ' physical condition but also completing the exercise, diet, smoking, drinking and family history, and, in addition, also provides resident identity card numbers and home addresses, and some residents fear privacy backlash. "However, do not fill in this information, the health record will null and void. "The doctors said.
Filing person: GP
Resident doctors build more barriers
Talking about health archives not only some residents do not buy it, many doctors lamented "difficult."
"The district has 60,000 residents, GP has only a few, the task this year is to complete the residents in the 80% health records. "In a community hospital officials said setting up health records cause work to be carried out, and generally settle now.
The official told new Express Reporter, although the community hospital was placed under public category of institution, staff are paid, but the evaluation, monthly salary will hang up. "Finish related tasks if the year-end assessment or assessment failed, would withhold the money. ”
"Heavy workload, there is no time to do this. "The yuexiu district in a community hospital staff asked health records established, bluntly said that hospitals do not have enough energy to carry out this work, and this situation does not only appear in this hospital. "Our hospital has GP 8 people, is responsible for 80,000 residents, is that too few people, to build the archives, see? "A community hospital in charge, usually already heavy burden of diagnosis and treatment, for the establishment of health records, can do to residents when seeking medical care for residents, usually occasional household surveys.
B file be trouble
Fear unfinished task deduction
Doctors had to fake
"The workload rises every year 10%. "A community health service center in liwan District Chief told reporters, nearly 60,000 residents within their respective jurisdictions, the work done this year is probably the area resident population, living more than half of migrant health records will be set.
"In order to complete an objective task and had to fake it. "A community health service center official bluntly told the new express reporters, the current residents, fewer doctors, residents do not fit the status quo so that health records established in the eyes of some community physicians became" impossible task "," even if we're working 24 hours, it's hard to finish ".
What fraud? "The resident's name, telephone information, doctors to fill in the residents ' health records here. "Community hospital official. New Express Reporter interviewed, haizhu, Tianhe, yuexiu district, and many community hospitals indicated that this situation also exists, according to a Director, although the construction of regular archives sent a team of doctors and nurses in hospitals, but the arrangement is that it is hardly the end of the workload.
Some community hospitals, said health record has basically covered all older people and those with chronic diseases within the community. But for the work of young people and adolescents, health record still belongs to the vacant, only fake.
Information difficult to update idled into "dead file"
Home after filling out health records, doctors back to the hospital, you also need to put these files into the computer. Dr Lee in a community, health records is currently in a personal way files, archived at family, family health records will be added in the future. "Through the network, community doctors can query at any time to modify their tenants ' information to manage their health status. ”
"Health record established was difficult, but how is the more important. If you just lock into the closet, and honestly makes no sense. "The community doctors, who asked not to be named told the new Express Reporter, health file creation needed after regular visits, visits workload is too heavy, some health records has become a" dead document. "
The municipal health Bureau:
Does not want to finish the job and build a fake document
"You reflect the problems, in fact we also know, in accordance with demands adjustments to the work programme, objectives and tasks of the parties. "For residents, and primary hospitals reflect paper health records dilemma in the construction of, new express reporter recently interviewed the Guangzhou Municipal Health Bureau official.
According to the City Health Department response, unified information platform in the city is advancing, then paper file will be replaced with electronic records, and resident health records will be in the hospital for networking, you can shift at any time, update. Grass roots less manpower, workload issues, the official said, would reduce workload, "we do not want the fraud in order to complete the objectives and tasks, preferring to reduce the amount of tasks, requires quality assurance".
Focus questions
Q: finance how much you spend?
Answer: the Community Hospital complete package of essential public health service now costs 40 Yuan per year per resident population of grant, which contains national 3.5 Yuan and the rest by financial arrangements at the municipal and district levels. 40 dollars including health records, health education, vaccination and other public service package of 11 items, packaged amount.
Q: community says file is difficult.
Answer: in fact, there are many ways to establish archives, such as through household services (investigation), disease screening, physical examination and other methods. Due to the current Community Hospital visiting rate of less than 30%, and does allow residents to a community hospital and complete health record has a little difficulty, also resulted in difficulties of this work.
Q: after setting up health records it won't work?
Answer: "die" can't say no. To address this problem, we are working vigorously to speed up the construction of information systems, and to facilitate information sharing between the size of the city. In 2010, Guangzhou has been carried out to establish a unified information platform for regional, municipal medical institutions in Guangzhou this year, more than half of the district's more than more than 100 grass-roots hospitals already networking, based on this platform, electronic archive of 800duowanfen have been completed.
Q: grass-roots hospital said the fraud was compelling.
Answer: tens of thousands of documents, we can't guarantee that every exact, true, did not rule out some community hospitals acts of fraud. Of course, we are against fraud in order to complete the objectives and tasks. Existing manpower of community is indeed very tight, per million inhabitants currently configured 8 GP's goal is not achieved, pressures at grassroots medical institutions. They reflect the 90% files rate workload is too heavy, we will realistically adjust to lower targets. Objectives and tasks cannot be lower than the national and provincial requirements.
Expert view
Liao Xinbo: with electronic medical record EHR automatically generates
Province has always been concerned about health reform Planning Commission inspector, said Liao Xinbo, he would have noticed that the grass-roots level reflect the health records of file problem. Yesterday, he said in an interview with the express, no paper files of information systems supporting performance is a marvel of formalism and bureaucracy.
He raised one step to create an electronic health record. He said, with the electronic medical record, electronic health record "natural" form. Most paper health records is now meaningless, at best, is a health census.
"A birth is a file; entrance examination and vaccination, one at a time to see a doctor is data collection even pre-marital check up, prenatal health records begins to form. This paper is stuck with the electronic health record. If you cannot accumulate personal health information and statistics of paper files to do? "He says it's not parallel to the paper and the electronic problem, but the problem of thinking breaks. A complete electronic health record system is the sum of multiple systems. Is also a reflection of a co-ordination and administrative capability of the Government's performance, but the current system highlights the huge waste in the informatization construction!
Liao Xinbo calls in an electronic information system is not connected when it is constructed, establishment of paper health records should be prudent or even dismissed.
(Original title: GP fact: health records more than half of fraud)
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