论文部分内容阅读
目的探讨医院转科病案的质量。方法本文通过对630例住院转科病案质量的调查并对其进行分析,找出存在问题,提出改进措施。结果病历质量缺陷率由原来的51%下降到14.8%,取得了显著的效果。结论随着人们的法治观念不断增强,病案质量更显得重要,它不仅为医疗、教学、科研提供大量的科学资料,而且也为医疗质量、技术水平、管理水平的综合评价以及医疗纠纷提供依据和第一手法律资料。
Objective To investigate the quality of hospital transfer cases. Methods This paper analyzed the quality of 630 cases of hospitalized medical records and analyzed them to find out the problems and proposed improvement measures. As a result, the medical record quality defect rate dropped from 51% to 14.8%, and achieved remarkable results. Conclusion With the continuous enhancement of people’s concept of the rule of law, the quality of medical records is more important. It not only provides a large amount of scientific information for medical treatment, teaching, scientific research, but also provides a basis for the comprehensive evaluation of medical quality, technical level, and management level as well as medical disputes. First-hand legal information.