How to control and prevent common diseases in a community health joint defense service management system?

Community health service takes people's health as the goal, takes families as the unit, is demand-oriented, makes full use of community health resources and appropriate technologies, integrates prevention, medical treatment, health care, rehabilitation, health education and family planning technical services, and provides effective, economical, convenient, comprehensive and continuous primary health services with emphasis on women, children, the elderly and the disabled (including floating population).

Lot hospitals are the main community health service institutions. It is necessary to change functions, update management system, adjust internal structure and operation mechanism, establish community health work network, improve health records, give play to information guidance function, and carry out work from six aspects: prevention, health care, medical treatment, rehabilitation, health education and family planning technical services.

I. Community prevention

(A) the work content of the community health service center

Prevention and control of infectious diseases

(1) Prevention and control of acute infectious diseases: report, verification and statistics of acute infectious diseases, quality control of reports, investigation of missing reports by community medical institutions and residents, investigation of cases of acute infectious diseases, visit and management, treatment and management of epidemic spots, publicity and education on prevention and control of infectious diseases in communities; Assist in the investigation and handling of sudden outbreaks and unexplained disease outbreaks; Carry out monitoring of key infectious diseases, including case monitoring and pathogen monitoring sampling, and assist in epidemiological investigation; Open intestinal specialist clinics and hepatitis specialist clinics.

(2) Immunization prevention: the key point is planned immunization. Timely grasp the immunization service targets, establish vaccination certificates, cards, books, vaccines and cold chain management, carry out vaccination clinics, and implement vaccination work; Routine immunization coverage survey and planned immunization data management; Finding, monitoring and reporting diseases related to immunization prevention; Discovery, registration, reporting and handling of vaccination reactions and accidents; Assist in the evaluation of population immunization status and vaccine effect.

(3) Prevention and treatment of tuberculosis: discovery and report of tuberculosis; Referral of suspected or confirmed patients; Grasp the situation of non-hospitalized patients in time, treat, follow up and manage non-hospitalized patients, train, guide and urge family supervisors to manage patients; Registration, summary and reporting of tuberculosis control data.

(4) Prevention and treatment of parasitic diseases: blood test for patients with "Four Fever", positive registration and monitoring of plasmodium in blood smear; Longitudinal monitoring of filariasis and treatment of advanced patients; Isolate the "three diseases" and treat the positive patients hypothetically; Carry out prevention and treatment of intestinal parasitic diseases.

(5) vector disinfection: monitoring the insect situation of sanitary pests and urban pests, and collecting monitoring samples of pest ecology and drug resistance; Technical guidance and effect evaluation of pest treatment; Disinfection of epidemic spots of infectious diseases (terminal and follow-up disinfection); Monitoring and management of disinfection of family sickbeds; Preventive disinfection management in nurseries and pension institutions.

(6) STD and AIDS prevention: STD case report, registration and statistics; Medical guidance and services, follow-up, consultation and management of HIV/AIDS patients; Carry out public health education, consultation and behavioral intervention on sexually transmitted diseases and AIDS; Assist in the special monitoring and management of sexually transmitted diseases and AIDS.

(7) Management of floating population: In addition to the above (1), (2), (3), (4), (5) and (6), it is necessary to do a good job in the prevention and control of infectious diseases among floating population, and also to carry out health examination for floating population; Carry out publicity and education on disease prevention.

2. Management of chronic non-communicable diseases

(1) information and monitoring: establish family health records, including core parts and special parts; Population hypertension measurement, including the first blood pressure measurement of people over 35 years old; Tumor monitoring, including investigation and follow-up of incidence, death and current symptoms; The organization and management of early detection of cancer in high-risk groups, including the organization and management of monitoring and follow-up of high-risk groups of liver cancer, gastric cancer, intestinal cancer and breast cancer.

(2) Health education: Carry out community health education on smoking, alcoholism, hypertension, unbalanced diet, obesity, sitting habits and mental stress.

(3) Management of patients with chronic diseases: classified management of hypertension patients, classified management of cancer patients, management of patients with type I and type II diabetes, management of patients with chronic obstructive pulmonary disease, and management of patients with bone and joint diseases.

3. Preventive health care in schools: establishing archives of basic conditions in schools; Monitoring students' health and school environmental sanitation, including physical examination, monitoring absence due to illness, and monitoring classrooms, desks and chairs; Evaluate the growth and development of students; Monitor and prevent common diseases of students, including trachoma, poor eyesight, malnutrition and obesity, intestinal worms, anemia and dental caries; School lunch nutrition and food hygiene, including balanced diet guidance, food safety and hygiene guidance; Carry out school health education and school health promotion, establish health promotion schools, and investigate the risk factors affecting students' health.

4. Nutrition and food hygiene: food hygiene and nutrition health education, including factors affecting food safety (pathogenic microorganisms and environmental pollutants), causes and prevention of food poisoning, causes of malnutrition (including undernutrition and overnutrition) and balanced diet; Nutrition and dietary guidance for special people, including dietary guidance for the elderly, infants, pregnant women, hypertensive patients and diabetic patients; Monitoring of iodine deficiency disorders, including the organization and management of salt iodine and urine iodine monitoring.

5. Environment and occupational health: master the quality of drinking water and carry out monitoring and management of soil well disinfection; Indoor pollution control, kitchen fume health guidance, home decoration and prevention of passive smoking hazards; Guidance on the safety of household chemicals, and guidance on pesticides, fuels, solvents, detergents and cosmetics; Control accidental injuries and carry out health education to prevent traffic safety and gas poisoning; Occupational health service, monitoring and sampling, occupational health archives and health consultation for small enterprises; Visit patients with occupational diseases, including pneumoconiosis and chronic poisoning follow-up.

6, vital statistics: birth survey statistics, grasp the birth situation and demographic information of the population; Investigation and statistics of the cause of death, issuing death inference to the family of the deceased, visiting the family of the deceased to investigate the cause of death, and mastering the death information of the family of the deceased; Retrospective investigation of infant death.

7. Prevention and treatment of mental illness: collect and summarize relevant information of mental patients, make statistics and fill in statements; Establish a "psychiatrist's clinic" to carry out prevention, rehabilitation and education; Guide the rehabilitation treatment in the occupational treatment station, guide the grass-roots personnel to care and manage patients, and implement rehabilitation measures.

8. Prevention and treatment of dental diseases: carry out oral hygiene education and establish information on prevention and treatment of dental diseases; Complete dental treatment for children in primary and secondary schools and kindergartens; Monitoring dental diseases of all ages; Guide grassroots personnel to carry out dental disease prevention and treatment.

9. Eye prevention: carry out prevention and treatment of blindness, check the eyesight of the elderly over 60 years old, grasp the situation of new blindness, mobilize surgical treatment, and reduce the blindness rate; Prevention and treatment of acute conjunctivitis, management of public places, epidemic registration and reporting; Organize children's examinations regularly to prevent amblyopia and low vision; Carry out publicity and education on the prevention and treatment of myopia, trachoma, trauma and occupational eye diseases.

(two) the work content of community health service points

Prevention and control of infectious diseases

(1) Prevention and treatment of acute infectious diseases: mastery, verification and reporting of infectious diseases; Assist in the investigation and handling of epidemic spots, and assist in the investigation of missing reports; Assist patients to see a doctor and investigate cases, and track pathogen carriers and contacts; Carry out publicity and education on the prevention and treatment of infectious diseases.

(2) Immunization prevention: master the vaccination situation of immunization service targets, mobilize foreign children to vaccinate, and issue vaccination notices; Find and report suspected cases corresponding to planned immunization; Assist in investigating and monitoring the immunization coverage rate.

(3) Prevention and treatment of tuberculosis: finding, referring and reporting suspected cases, and mastering the examination objects of floating population; Master non-hospitalized chemotherapy patients and supervise short-term chemotherapy; Guide and urge family supervisors to manage patients; Educate patients and their families about tuberculosis prevention and treatment.

(4) Prevention and treatment of parasitic diseases: discover and report suspected cases of "four fevers"; Master the targets of malaria monitoring, kill mosquitoes in malaria epidemic spots, and supervise the treatment of malaria patients; Master the monitoring objects of filariasis and follow up the patients with advanced filariasis; Grasp the quarantine objects of "three diseases" and mobilize quarantine.

2. Management of chronic non-communicable diseases

(1) information and follow-up: assist in establishing family health records and follow up regularly; Blood pressure measurement of community residents and high-risk groups; Follow-up of tumor patients.

(2) Health education: Carry out community health education for smoking, alcoholism, hypertension, unbalanced diet, obesity, sitting habits, mental stress and other risk factors.

(3) Management of patients with chronic diseases: assist in grading management of patients with hypertension, cancer, type I and type II diabetes, chronic obstructive pulmonary disease and bone and joint diseases.

3. School preventive health care: master the basic situation of the school and assist in establishing the basic situation file of the school; Assist in monitoring students' health and school environmental sanitation; Assist in monitoring and preventing common diseases among students; Guide school lunch nutrition and food hygiene; Cooperate with school health education and school health promotion.

4. Nutrition and food hygiene: discourage families from organizing banquets by themselves and publicize reasonable nutrition.

5. Environment and occupational health: supervise the implementation of soil well disinfection and test the disinfection effect; Carry out health education on preventing gas poisoning and traffic safety at the grassroots level in the community; Visit patients with occupational diseases, including pneumoconiosis and chronic poisoning follow-up.

6. Prevention and treatment of mental illness: master the condition dynamics of mental patients, register new cases, move in and out, and disappear cases, and fill in relevant reports; Implement an intensive prevention and rehabilitation plan, and visit and record it regularly; Guide the activities of home nursing network and carry out mental health education.

7. Prevention and treatment of dental diseases: mastering oral health; Follow up and supervise the treatment of dental patients; Carry out oral health education.

8. Prevention and treatment of eye diseases: eyesight examination and blind report for the elderly over 60 years old; Simple treatment, follow-up and supervision of eye trauma and general eye diseases; Assist in establishing eye disease data; Carry out publicity and education on prevention and treatment of eye diseases, and mobilize those who can cure blindness to actively treat them.