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目的分析边疆多民族地区病案复印中存在的问题,改善病案复印流程,提高病案复印的质量、速度及准确性。方法针对2014年-2016年多民族边疆地区某三甲医院病案资料登记表的数据进行回顾性分析。结果逐步完善病案复印的各项管理后,病案复印人数从2014年的48 238例增加到2016年的76 871例,增长率159.36%,并且病案复印的一次成功率从2014年的72.52%(34 982例/48 238例),提高到2016年的97.07%(74 615例/76 871例)。结论由于患者证件不齐、工作人员复印内容不全、病案未能提供及复印技术问题等原因导致病案复印的一次成功率较低,通过加大多种语言形式宣传及服务技能培训力度、优化复印流程等措施,提高病案复印的准确性及速度。
Objective To analyze the existing problems of medical records in multi-ethnic border areas, improve the process of medical records copying, and improve the quality, speed and accuracy of medical records. Methods A retrospective analysis was made on the data of the registration forms of medical records of some top three hospitals in the border regions of the multinationals from 2014 to 2016. As a result, the number of medical records was gradually increased from 48,238 in 2014 to 76,871 in 2016, a growth rate of 159.36%. The success rate of medical records from 72.52% in 2014 (34 982 cases / 48 238 cases) and increased to 97.07% (74,615 cases / 76,871 cases) in 2016. Conclusions The success rate of medical record copying is low due to the lack of patient documents, incomplete copies of staff members, failure to provide medical records and technical problems of copying. The success rate of medical record copying is relatively low. Through more training in various forms of language publicity and service skills, the photocopying process is optimized Measures to improve the accuracy of medical records and speed.