ࡱ> _ Xbjbj 4bb% {{{{{8t(" . : sssssss$wy^t{/!@ /!/!t{{t###/!{{s#/!s##.ks.^/!Lo@st0to+z{!+zs+z{s8B "d #|  B B B ttY#B B B t/!/!/!/!+zB B B B B B B B B ! A:  S Y T LM NG TRUNG TM Y T LM H  S: /KH-TTYT CNG HA X HI CH NGH(A VIT NAM c lp  T do  Hnh phc  Lm H, ngy thng nm 2020  K HOCH Cng tc y t Giai on 2021-2023 Cn c Thng t s 38/2019/TT-BTC ngy 14 thng 8 nm 2019 ca B Ti chnh hng dn xy dng d ton ngn sch nh nc nm 2020, k hoch ti chnh 3 nm 2020-2022; k hoch ti chnh 5 nm tnh, thnh ph trc thuc Trung ng giai on 2021-2025; Cn c cng vn s 3033/BYT-KHTC ngy 02 thng 6 nm 2020 ca B Y t v/v xy dng k hoch v bo m kinh ph thc hin cc nhim v chi  c b tr t ngn sch CTMT Y t- Dn s cho giai on 2021-2025; Cn c K hoch s 540/KH-SYT ngy 15/5/2020 ca S Y t Lm ng v pht trin s nghip y t giai on 2021-2025, Cn c cng vn s 1599/SYT-KHTC ngy 02/7/2020 ca S Y t v/v: hng dn lp k hoch cng tc y t v d ton ngn sch nh nc 2020 v giai on 2021-2023. Trung tm y t huyn Lm H (TTYT Lm H) xy dng k hoch cng tc y t giai on 2021-2023 ti huyn Lm H vi cc ni dung nh sau. Phn th nht nh gi kt qu thc hin ch tiu k hoch, nhim v giai on 2018-2020 I. Ch tiu pht trin y t Cn c Ngh quyt s 08-NQ/HU ngy 11 thng 12 nm 2017 ca Huyn y Lm H Ngh quyt v pht trin kinh t -x hi bo m quc phng, an ninh xy dng ng v h thng chnh tr nm 2018. T l tng dn s t nhin xung di 1,14% T l tr em di 5 tui suy dinh dng di 11,6%, suy dinh dng th thp ci xung di 16,3%. T l ngi dn tham gia BHYT t trn 84-90% T l dn vng nng thn c s dng nc hp v sinh t trn 96%. II. Kt qu thc hin 1. c im a bn qun l huyn Lm H: Lm H l mt huyn min ni pha bc tnh Lm ng vi dn s l 144.808 ngi, ton huyn c 16 n v hnh chnh 02 th trn v 14 x, 177 thn, khu ph. C 30 dn tc anh em ang sinh sng trn a bn huyn, dn c phn b gm nhiu thnh phn nh: ngi dn tc gc Ty Nguyn, ng bo kinh t mi H Ni, H Ty, ng bo dn tc thiu s pha bc, ng bo cc tnh min ng Bc, min Trung, Nam B& Trong nhng nm qua, di s lnh o, ch o ca cc cp y ng, chnh quyn, s phi hp c hiu qu ca cc ban, ngnh, on th, s hng ng ng thun ca nhn dn, cng tc bo v, chm sc v nng cao,  khc phc c s xung cp ca cc c s y t, nhiu bnh dch mi nguy him  c pht hin v ngn chn kp thi, nhiu ch tiu v chm sc sc khe nhn dn t v vt Ngh quyt  ra. Ton huyn c 01 trung tm y t t tiu chun bnh vin hng III, 02 phng khm a khoa khu vc, 16 trm Y t v 02 phn trm. Tt c cc c s y t u c u t, nng cp v c s vt cht  v trang thit b y t. i ngi cn b cng chc, vin chc c tng cng c v s lng v cht lng, c bn  p ng nhu cu chm sc sc khe ban u cho nhn dn trn a bn. 2. Pht trin t chc b my, ngun nhn lc TTYT: - u nm 2018 TTTYT Lm H vi quy m 110 ging bnh, bao gm 4 phng chc nng, 7 khoa, 2 i, 2 PKKKV v 16 TYT x. n nm 2019 thc hin Quyt nh s: 1386/Q-UBND ca UBND tnh v sp nhp Trung tm dn s vo TTYT v Quyt nh s 1625/Q-SYT ngy 26 thng 9 nm 2019 ca s Y t Lm ng ban hnh Quy nh chc nng, nhim v v c cu t chc cc phng chc nng, Khoa chuyn mn, Trm Y t v tng ng ca TTYT huyn. n v hin c 01 khu iu tr trung tm quy m 110 gng bnh t tiu chun bnh vin hng III ( 05 phng chc nng, 10 khoa), 2 PKKKV v 16 TYT x  Th trn, c bn p ng c bn nhu cu khm, iu tr ca nhn dn trn a bn huyn. - Trm y t x- Th trn c quy m 02 ging lu bnh/trm; nhim v ch yu l thc hin chc nng y t d phng, tim chng m rng, qun l cc chng trnh y t , khm, cha cc loi bnh thng thng v cung cp dch v k hoch ha gia nh. Vai tr, v tr ca mng li trm y t cc x dn c khng nh. Cc chng trnh y t quc gia c trin khai v thc hin c hiu qu. Cng tc chm sc sc khe ban u, phng chng dch bnh, chm sc sc khe sinh sn, chm sc ngi cao tui v t vn, truyn thng gio dc sc khe, dn s - k hoch ha gia nh  to c chuyn bin mnh m, nhn thc ca cn b v nhn dn v bo v sc khe cho c nhn, gia nh v cng ng c nng ln. - Phng khm a khoa khu vc (Nam Ban v Khu Vc Tn H) vi s ging lu bnh ca PK Nam Ban l 8, PK Tn H: 04. Thc hin chc nng nhim v s cp cu v khm, cha bnh thng thng trn a bn. * Cht lng ngun nhn lc hin nay: - Pht trin nhn lc giai on 2018-2020: - Nm 2018, ngnh y t ton huyn c 277 cn b y t ( cha tnh dn s) , t l 3,7 bc s)/10.000 dn; 16/16 trm Y t c bc s), 100% thn, khu ph c nhn vin chm sc sc khe ti cng ng, trong  c 70% s nhn vin y t thn bn c o to c bn 03 thng tr ln. - T nm 2017 thc hin gim bin ch theo l trnh ( 4 nm gim 10% so vi bin ch c giao nm 2015), tnh n 2020 tng s bin ch ca TTYT c giao l 267 ngi. Hin tng s con ngi lm vic ca TTYT l 287 ngi (trong  c 20 bin ch lm cng tc dn s, 17 hp ng theo Ngh nh 68 ). -  p ng yu cu v ngun nhn lc gp phn cng c v hon thin mng li Y t c s, ngnh y t  c bit quan tm n cng tc o to, bi dng chuyn mn nghip v, l lun chnh tr, qun l nh nc, cng tc pht trin ng cho i ngi cn b y t tng tuyn. Qua 3 nm  c 86 cn b i o to nng cao trnh  chuyn mn, chnh tr, qun l ( 7 Bc s) chuyn khoa I, 6 bc s) a khoa, 01 c nhn sinh hc, 9 c nhn iu dng, 23 Cao ng iu dng, 4 qun l nh nc, 3 trung cp l lun chnh tr, 21 qun l bnh vin ...). Hng nm ngnh y t thng xuyn c cn b t huyn n c s i o to, tham gia cc lp tp hun nng cao v trnh  chuyn mn nghip v, y c cho i ngi cn b y t. - Sau 03 nm i ngi cn b ngnh Y t huyn Lm H khng ngng nng cao v cht lng, c bn p ng yu cu nhim v, c cu cn b tng bc cng c theo hng ph hp vi v tr vic lm, n nay ngnh y t ton huyn  c 287 cn b y t (tng 3,8% so vi nm 2018), trong  (02 bc s) chuyn khoa II, 17 bc s) chuyn khoa I, 41 bc s) a khoa, 03 Dc s) i hc, 58 y s), 51 iu dng, 44 N h sinh. T nm 2018 - 2020  kt np cho 11 ng vin, 12/16 Trm Y t c Chi b, n nay ngnh y t ton huyn  c 1 t chc c s ng (ng b TTYT). - Nm 2020 t t l 4,3 Bc s)/10.000 dn), trong  c 16/16 x, th trn c Bc s) phc v thng xuyn, t 100% ch tiu k hoch  ra. m bo mi trm y t c t 5 - 10 cn b y t, 100% trm y t c n h sinh trung hc tr ln, cc trm y t u c cn b bit v y hc c truyn, nha hc ng& 100% thn c nhn vin y t hot ng, c 187 nhn vin y t thn v 295 cng tc vin dn s c trnh  s hc hoc  c o to c bn v chuyn mn y t cng ng. i ngi cn b y t hc ng c cng c v pht trin nhm p ng yu cu chm sc sc khe ban u cho hc sinh cc trng hc trong huyn. Cng tc o to cn b y t l ngi a phng c bit l ngi dn tc gc Ty Nguyn c ch trng, c bit trong 3 nm tip nhn 5 Bc s) o to theo a ch, o to c tuyn. Hng nm u xt duyt cho cc i tng y s), iu dng, n h sinh trung cp c c i o to  nng cao trnh  chuyn mn nghip v t chun cao ng tr ln. * Thc trng v c s vt cht v trang thit b: - V c s vt cht: Nh c s h tr ca Tnh v cc ngun vn hp php khc TTYT c u t xy mi, nng cp m rng v c s h tng, khu trung tm  p ng c quy mi 110 gng, 2 PKKKV v 15 TYT u c xy dng kim c p ng yu cu thc hin nhim v chuyn mn. - V TTB y t:  tip nhn t s Y t 01 my XQ, 01 h thng m ni soi  bng, 02 ging cp cu, my xt nghin v u t thm mt s TTB gp phn nng cao cht lng khm cha bnh cho nhn dn  tuyn c s v gim tnh trng quti cho cc bnh vin tuyn trn. 3. Hot ng chuyn mn: 3.1. Phng chng dch bnh v thc hin cc chng trnh mc tiu 3.1.1. Cng tc phng chng dch bnh : Hng nm TTYT  ch ng xy dng v trin khai cc k hoch ngay t u nm (Phng chng dch chung, dch cm, dch hch, tay - chn - ming, st xut huyt, bnh do vi rt ZIKA, Ebola), ng thi cng c mng li phng chng dch t huyn ti thn bn m bo thc hin c vic gim st, x l mi trng v phn hi thng tin chnh xc. Cc hot ng phng chng dch bnh c duy tr thng xuyn v c n np, trong cc nm tuy khng xut hin trng hp cm A, bnh tiu chy cp nguy him v bnh Zika. Tuy bnh st xut huyt v tay chn ming c din bin phc tp nhng c kim sot v khng c bnh nhn t vong. Cng tc gim st dch hch trn a bn huyn tip tc c thc hin thng xuyn v c hiu qu. Phi hp vi vin Pasteur thnh ph HCM t chc gim st 2  dch hch ci, iu tra cn trng, ly mu ti x  n, kt qu cc ch s u  ngng an ton. Dch vim ng h hp cp do COVID-19: u nm 2020, Trung tm Y t  ch ng trin khai cc hot ng phng, chng dch theo ch o ca Th tng Chnh ph, B Y t, y Ban nhn dn Tnh, UBND huyn, s Y t Lm ng v phng, chng dch COVID 19; thng tin, truyn thng v dch bnh, chun b y  iu kin phng chng dch, gim st, x l mi trng, thc hin cch ly ngi c nguy c n t vng dch&  cch ly 24 trng hp, c th (Nht Bn 18, Hn Quc 05, Singapore 01); 01 trng hp cch ly ti CSYT, 14 trng hp cch ly ti c s tp trung, 242 trng hp xc minh thng tin trn phm mm Qun l thng tin COVID-19 v khng c ca bnh Covid-19 xm nhp vo a bn huyn Lm H. 3.1.2. Chng trnh mc tiu Y t- Dn s: * Hot ng phng, chng mt s bnh c tnh cht nguy him i vi cng ng: - Hot ng phng chng st rt: + Cng tc gim st c trin khai thng xuyn,  duy tr mng li t huyn, x n thn bn. + Thc hin lam xt nghim tm k sinh trng st rt trn ton huyn t ch tiu k hoch giao ca Tnh. + S trng hp bnh nhn s rt hng nm gim dn v khng c trng hp s rt c tnh. + Cp mn tm ha cht tn lu lu cho ngi dn i rng, ng ry ti cc x do D n RAI ti tr; - Hot ng phng chng phong: + Cng tc loi tr bnh phong c duy tr thng xuyn t huyn n x- th trn. Duy tr cng tc khm bnh da ti phng khm da liu, khm lng ghp bnh da ti cc TYT x - TT, khng pht hin bnh nhn phong mi. Hin ton huyn ang qun l cho 5 trng hp, chm sc tn ph cho 04 trng hp v gim st 01 bnh nhn. + Hon thin cng nhn t tiu chun loi tr bnh phong cp huyn nm 2016. - Hot ng phng chng lao: T chc khm v pht hin bnh nhn lao mi, thu dung v iu tr bnh nhn theo phc . T l bnh nhn iu tr khi t cao, t l bnh nhn b iu tr thp, s bnh nhn ti pht gim dn theo tng nm. - Hot ng phng chng st xut huyt: Cng tc phng chng st xut huyt, c bit quan tm ch o quyt lit ca S Y t, cp y chnh quyn a phng v trin khai ng b cc bin php gim st, x l mi trng (dit lng qung, b gy, dit mui), tnh hnh bnh dch din bin phc tp, hin ti bnh st xut huyt  gim dn. Nm 2018 ghi nhn 21 cas  c tip nhn iu tr khi v khng c cas t vong, 6 thng u nm 2020 ghi nhn 10 ca l t v c iu tr khi v khng bng pht dch. - Hot ng bo v sc khe tm thn cng ng: Cc hot ng pht hin, thu dung, qun l, iu tr bnh nhn tm thn phn lit v ng kinh c duy tr thng xuyn. - Hot ng PC Ung th: Nng cao nng lc cho i ngi cn b y t cc tuyn v d phng v qun l bnh khng ly nhim, c bit l ti tuyn y t c s thng qua cung cp cc ti liu hng dn chuyn mn k thut trong cc l)nh vc, t chc o to tp hun. Cng c h thng gim st, cp nht cc thng tin s liu theo di tnh hnh bnh tt, cc yu nguy c v nh gi kt qu cc hot ng phng chng bnh khng ly nhim. Cng vi , y mnh cc hot ng truyn thng nng cao sc khe ch trng vo tuyn truyn, hng dn, h tr ngi dn bit cch pht hin sm bnh thng qua cc bin php kim tra sc khe, sng lc ung th& , bit tun th iu tr ti nh khi mc bnh. S BN hin qun l: 322 BN, trong  c 1 s bnh ung th c t l mc cao nh: Phi 13,5% (43ca), Gan 12,5% (40 ca), v 10,7% (34 ca), C T cung 8,8% ( 28 ca), d dy 9,7% (31 ca) v i trng 6,9% (22 ca). - Hot ng phng chng i tho ng Hot ng phng chng i tho ng: Duy tr hot ng t vn, khm sng lc pht hin bnh i tho ng, tin i tho ng ti 16 TYT (04 x im). Tng s bnh nhn T ang qun l 793, t l iu tr u 59,1% - Hot ng PC Tng huyt p: T chc khm sng lc lng ghp pht hin bnh nhn tng huyt p ti 16/16 TYT x,TT. y mnh cc hot ng truyn thng nng cao sc khe ch trng vo tuyn truyn, hng dn, h tr ngi dn bit cch pht hin sm bnh thng qua cc bin php kim tra sc khe n gin nh o huyt p & , bit tun th iu tr ti nh khi mc bnh. Hin ton huyn qun l iu tr cho: 4613 BN, pht hin mi 327 ca. Phi hp vi i pht thanh, truyn hnh huyn tuyn truyn. ni dung: Nng cao nhn thc ca cng ng v phng chng cc bnh tim mch. - Hot ng phng chng bnh Phi tc nghn v Hen ph qun: Xy dng v trin khai k hoch huyn im. 100% bnh nhn c chn on, iu tr, t vn v a vo danh sch qun l. Thc hin t vn, khm thu dung qun l, iu tr cho bnh nhn theo ng quy nh ca chng trnh. Hin ti qun l 138 bnh nhn (trong  COPD: 58 , HPQ : 80). + X l cp cu,thu dung iu tr ti khoa Phng khm hi sc tch cc, khoa Ni nhim v 2 phng khm a khoa khu vc. + Chuyn bnh nhn ln tuyn trn  c o chc nng h hp nh gi tnh trng bnh, t vn iu tr. + Nm 2019 phi hp vi Bnh vin Bch Mai t chc lp tp hun cho cn b ph trch d n tuyn huyn v 16 trm y t ca huyn Lm H. Tip nhn 01 my o chc nng h hp t d n ca BV Bch Mai + Trin khai gim st, hng dn hot ng ti cc Trm y t 1 ln/qu/trm. 3.1.2. D n tim chng m rng: - 19 n v c t chc tim chng ti huyn c cp chng nhn  iu kin tim chng m rng. - Cc hot ng ca d n tip tc c cng c, thc hin m bo an ton v t cc ch tiu  ra. - Phi hp vi TTYTDP (CDC) tnh t chc lp tp hun an ton tim chng cho cn b ph trch chng trnh v cn b tham gia cng tc tim chng ti tuyn huyn, x. - Trin khai tim chng mt s loi vaccine mi theo quyt nh ca B Y t t kt qu v khng c tnh trng phn ng nng xy ra. * Kt qu thc hin trong cc nm: STTNi dungNm 2018Nm 2019Thc hin 6 thng 2020c Nm 20201Tr di 1 tui tim y 93,8%95%44,8%96%2T l PN c thai tim phng UV 2+98,2%96,1%48,9%96%3Tr 18 thng tim Si  Rubella94%96,1%45,3%96%3.1.3. D n Dn s v pht trin: - Hot ng DS-KHHG Tip tc qun trit Ngh quyt s 21-NQ/TW ngy 25/10/2017 Hi nghln th su Ban chp hnh Trung ng ng kha XII v cng tc dn s trong tnh hnh mi. y mnh cc hot ng m hnh nng cao cht lng dn s huyn trong tnh hnh mi. Tp trung thc hin Chin dch tng cng tuyn truyn, vn ng lng ghp, cung cp cc dch v nng cao cht lng dn s  c s ngay t u nm. i mi phng thc cung cp, nng cao cht lng dch v ti ngi s dng. m bo cung ng cc phng tin trnh thai min ph cung cp cho cc i tng theo ng hng dn v chtiu k hoch phn bhng nm. Trin khai sng lc sau sinh cho tr s sinh v b m mang thai trong ton huyn. Trin khai chin dch tng cng t vn, lng ghp vi cung cp dch v - k hoch ha gia nh v nng cao cht lng dn s hng nm t ch tiu k hoch giao. Kt qu : T l tng dn s t nhin 1,08% S ngi thc hin bin php trnh thai hin i trong nm t 19.475 ngi. T l s dng bin php trnh thai hin i t 74,6% T l b m mang thai c sng lc trc sinh t 31,6% T l tr em mi sinh c sng lc s sinh t 3,4% T s gii tnh khi sinh: 121 tr nam /100 tr n T sut cht tr di 1 tui l 8,50 ; - Hot ng phc hi chc nng cho ngi khuyt tt ti cng ng: Duy tr cc hot ng ca chng trnh PHCN theo k hoch; Tng s ngi khuyt tt c qun l 1711 ngi s ngi khuyt tt c nhu cu PHCN l 440/1711 = 25,7%; - Hot ng chm sc sc khe ngi cao tui: Trin khai cc hnh thc gio dc, ph bin kin thc ph thng v tp luyn, t chm sc, nng cao sc kho, phng, chng bnh tt cho ngi cao tui. Hin qun l 9825 ngi cao tui, trong nm s ngi cao tui n khm ti c s y t l 35573 lt, s ngi cao tui c khm sc khe nh k l 5768. - Hot ng CSSKSS: + Cng tc qun l thai nghn c quan tm thc hin, t l qun l thai cc nm t 97,8% KH, t l ph n  khm thai 3 ln tr ln trong thai k t 95,2% KH, ph n  c nhn vin y t  t 100%. + Tai bin sn khoa gim, khng c t vong m, t vong s sinh. - Hot ng ci thin tnh trng dinh dng tr em + Cng tc PC SDD TE c duy tr thng xuyn, trin khai mt s hot ng chnh, tuyn truyn, hng dn PC SDD, cn tr < 2 tui b SDD hng thng, cn o tr < 2 tui hng qu. T chc cn tr v ung vitamin A cho tr di 5 tui. T l SDD theo cn nng nm 2018 l: 11,6 % n nm 2020 gim cn 10,95%, th thp ci nm 2018 l: 16,60% n nm 2020 gim cn 16.25% . 3.1.4. D n phng chng HIV/AIDS: - T l nhim HIV/AIDS trong cng ng l 0,006%. Hin ti s ngi nhim HIV cn sng ang qun l: 109 ngi nhim HIV. S ngi nhim hin ang c iu tr ARV: 103 ngi. - Phi hp Trung tm PC HIV/AIDS t chc cc lp tp hun cho cn b ph trch chng trnh HIV/AIDS v CB ph trch cng tc CSSKSS trong ton huyn v k nng gim st, qun l, t vn. Tp hun kin thc v Lut phng chng ly nhim vi rt gy ra hi chng suy gim min dch mc phi cho YTTB trong ton huyn. 3.1.5. D n: An ton thc phm( ATTP): - T 2018-2020: c 3 v ng c thc phm ( trong  02 v di 30 cas, 01 v > 30 ca), khng c trng hp t vong. - T l c cp nht kin thc v an ton thc phm ca ngi sn xut, ch bin, kinh doanh thc phm t 90%, ngi tiu dng l 90% v ngi qun l l >90%. 3.1.6. D n: Theo di, kim tra, gim st, nh gi thc hin chng trnh v truyn thng y t - Theo di, kim tra, gim st nh gi bo m thc hin Chng trnh hiu qu. Trin khai cc hot ng truyn thng y t, ch ng gp phn phng, chng bnh tt nng cao sc khe ngi dn v cng ng. T chc tuyn truyn cho ngi dn v cc bnh dch nh st xut huyt, tay chn ming, si, cm A H1N1, A H5N1, Covid-19& T chc truyn thng nhn ngy th gii phng chng Lao, thng hnh ng HIV/AIDS, ATVSTP. - Phi hp vi i PTTH huyn thc hin cc phng s, bn tin tuyn truyn phng chng dch bnh (TCM, SXH& ), phng chng ng c thc phm, phng chng HIV/AIDS, phng chng ung th, phng chng tng huyt p. 3.1.7. Cc chng trnh y t khc: - Chng trnh sc khe mi trng: T chc trin khai hng ng cc hot ng: Tun l nc sch & VSMT, ngy Mi trng Th gii 05/6 hng nm, k hoch lm cho Th gii sch hn. Xy dng KH v trin khai cc hot ng gim thiu cht thi nha s dng mt ln ti cc c s y t trong ton huyn. + Ti TTYT v 16/16 TYT x/TT c s dng ngun nc, nh tiu HVS  phc v cho cc hot ng KCB. + T l HG c ngun nc HVS: t 91,5%. + T l HG c nh tiu HVS: t 77,4%. - Chng trnh sc khe ngh nghip Hng nm t chc truyn truyn nhn tun l VSL, tham gia cng on kim tra lin ngnh ca huyn v t t chc kim tra cng tc ATVSL-PCCN. Tng bc t chc qun l cc c s s dng lao ng trn a bn huyn theo quy nh. 3.2. Cng tc khm cha bnh: 3.2.1. Kt qu khm cha bnh - Nm 2020 t 16 ging bnh/ vn dn. T l bao ph BHYT ton dn c xu hng tng: Nm 2018 l 88% c thc hin nm 2020 l 90%. - m bo cng tc cp cu, khm bnh, cha bnh ti cc tuyn. Ti bnh vin huyn  x l tt cc trng hp cp cu ngoi khoa, sn khoa, trin khai cc dch v k thut mi trong l)nh vc chuyn khoa Rng  Hm  Mt, Tai  Mii  Hng, Mt, Y Hc C Truyn. Trin khai ng dng cng ngh thng tin trong qun l khm cha bnh. Thc hin tt quy ch bnh vin, ci cch th tc hnh chnh trong cng tc khm, cha bnh. Tinh thn trch nhim, k nng giao tip ng x ca cn b vin chc c nhiu chuyn bin tch cc to nim tin trong nhn dn. - 16/16 Trm Y t c vn thuc nam, c YHCT hot ng. Hot ng ca Khoa Ni- YHDT ti Trung tm Y t hot ng c hiu qu, t l bnh nhn khm cha bnh bng YHCT ngy mt tng. i ngi y bc s YHCT y  v s lng v cht lng, thuc YHCT m bo v vy s bnh nhn n iu tr ni tr v ngoi tr bng YHCT. Kt qu thc hin giai on 2018-2020 khm cha bnh: STTNi dung Nm 2018 Nm 2019Thc hin 6 thng 2020c nm 20201S ln khm bnh247.370244.285101.836228.0002S bnh nhn iu tr ngoi tr19601.83980317483Tng s ngy iu tr ni tr3813432.4881148534.1274Tng s phu thut6073461483905CSSDGB95%80,9%57,8%87,2%6Tng s ln chp Xquang3384131.96412.93128.5007Tng s ln siu m23.94522.6739.74520.3308Tng s ln in tim1.8662.6611.0712.0009Tng s ln ni soi89289635780710Tng s ln xt nghim72.01777.43436.34068.8803.2.3. Pht trin k thut mi: - Trong giai on t nm 2018- 2020 TTYT  trin khai c 1 k thut Lm sng mi. * K thut lm sng: - Phu thut ni soi ct rut tha 3.3. Cng tc ch o tuyn, trin khai  n 1816. Nng cao cht lng KCB l nhim v u tin hng u, lun c ngnh y t quan tm thc hin. Thc hin cng tc ch o tuyn nhm nng cao cht lng KCB cho tuyn c s l mt trong nhng ni dung ca nhim v trn. Xc nh tm quan trng ca cng tc ch o tuyn, hng nm, Trung tm Y t  ch o cc khoa, phng phi ch trng n cng tc ny trong qu trnh hot ng. Ty theo tnh hnh thc t v nhu cu ca tuyn di, cc c s KCB tuyn trn u xy dng k hoch trin khai thc hin. Cc c s tuyn di cing xy dng k hoch cn tuyn trn h tr, hng dn, chuyn giao nhng k thut, chuyn mn ph hp vi n v mnh. T cng tc ch o tuyn hng nm, nhiu k thut  c tuyn trn chuyn giao, o to cho tuyn di. Nhiu nm qua, cc Khoa, phng  chuyn giao cho TYT cc k thut. T   gip cc TYT hon thin quy trnh chn on iu tr, trin khai c nhiu k thut mi; gp phn tch cc trong vic nng cao cht lng KCB, thc hin nhim v chm sc sc khe cho nhn dn ngy cng tt hn. 4. Cng tc Dc, trang thit b y t: - Trin khai thc hin tt cc qui ch chuyn mn dc ti cc c s khm cha bnh. C bn m bo cung ng thuc, ha cht cho nhu cu khm cha bnh, d phng; Cht lng thuc, gi thuc v danh mc thuc tng bc c kim sot, to s an tm cho ngi bnh v cn b y t. - T chc u thu vt t, ha cht, phim X quang, vc xin theo ng qui trnh, quy nh. - Hi ng thuc v iu tr  duy tr cc hot ng thng xuyn. 5. Cng c y t c s (tuyn x) Nm 2018 n nay, c 16/16 x t v gi B tiu ch quc gia v y t x giai on n 2020. Nm 2020 c 14/14 x xy dng nng thn mi t tiu ch y t (tiu ch 15) ca b tiu ch quc gia v nng thn mi, 02 Th trn xy dng  th vn minh: TT Nam Ban, TT inh Vn. Trin khai hot ng cc trm y t theo nguyn l y hc gia nh theo Quyt nh s 1568/Q-BYT ngy 27/4/2016 ca B Y t v vic ph duyt k hoch nhn rng v pht trin m hnh phng khm bc s) gia nh ti Vit Nam. 100% Trng trm y t c tham gia cc lp o to v qun l y t, cn b trm c o to  Chm sc sc khe ban u theo nguyn l y hc gia nh . 6. u t pht trin giai on 2018-2020: - Giai on 2018-2020, c s quan tm ca s Y t Lm ng, ca huyn Lm H, Y t tuyn c s c tp trung u t c v c s vt cht, trang thit b bng nhiu ngun nh s s kin thit,  xy mi 3 trm Y t (Phi T, Phc Th, Hoi c), Khu Vn Phng vi tng kinh ph 17 t ng. - Sa cha khoa Ni -Nhim, Nhi, TYT Gia Lm vi tng kinh ph 1,679 t ng. n nay c s vt cht ca khu iu tr trung tm, 2 phng khm a khoa khu vc, 16 trm Y t x, th trn m bo kin c ha v t chun theo quy nh. - TTYT huyn  tip nhn v a vo s dng cc trang thit b t cc ngun d n v ngn sch s nghip y t, ti bnh vin, 02 phng khm a khoa khu vc v cc trm Y t x, th trn (H thng m ni soi& ) vi tng tr gi 11,995 t ng. 7. Cng tc thanh tra Hng nm TTYT xy dng k hoch v t chc thanh tra th trng ti cc n v theo k hoch. 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Chun b thuc, trang thit b, phng tin cp cu sn sng phc v nhn dn. Bn cnh , vn cn mt s CBVC cha chp hnh tt ni quy v trang phc, cha chp hnh tt ni quy v gi gic, cha c s nht k c nhn. Ch nh thuc trn HSBA cha ng theo thng t 23/2011/TT-BYT, ghi chp HSBA, s A1 cha y  ct, mc, cha y  cc biu mu theo quy nh 8. Cng tc x hi ha y t giai on 2018-2020 - Cng tc x hi ho y t  c s chuyn bin trong nhn thc v c s phi hp c hiu qu gia cc cp u ng, chnh quyn v cc ban, ngnh, on th trong ton huyn. Thc hin tt cng tc lnh o, ch o cc ban ngnh, on th, cc c quan, n v trn a bn thc hin c hiu qu cng tc tuyn truyn, gio dc nng cao nhn thc ca nhn dn trong vic bo v, chm sc v nng cao sc kho bn thn, gia nh v cng ng. - Thc hin ch trng x hi ha y t, UBND huyn  ch o ngnh y t, cc ban, ngnh lin quan phi hp vi cc t chc, a phng to mi iu kin thun li nhm khuyn khch s u t, h tr nhm pht trin ca h thng y t cng lp v ngoi cng trn a bn huyn. Bng cc ngun vn ca chng trnh mc tiu Y t quc gia, UBND thnh ph H Ni, h tr ca tnh, huyn, ngun s s kin thit, Ngnh y t huyn  t chc tip nhn v s dng c hiu qu cc d n u t xy dng, h tr trang thit b y t ti Trung tm Y t huyn v cc trm y t. - Nm 2018, 2019 TTYT  xy dng  n x hi ha y t vi nhng dch v: siu m mu 3-4 chiu, X quang k thut s, phc hi chc nng& .. Trn l)nh vc y t d phng: - Trin khai tim vaccine dch v vi 4 loi vaccine, hng nm tim khong 6000 mii cho ngi dn trn a bn. 9. Cng tc qun l ti chnh : (Ph lc km theo) - Cc n v trc thuc thc hin nghim chnh cc quy nh ca nh nc v thu chi ngn sch. Trin khai xy dng v thc hin gi dch v y t theo quy nh ca nh nc, tnh ng, tnh  cc chi ph trc tip phc v bnh nhn. Cng khai minh bch vic thu, chi vin ph cho ngi dn bit. Thc hin thanh tra, kim tra, bo m vic s dung kinh ph ng hiu qu, ng mc tiu. - Cc ch  chnh sch chi cho cn b, cng chc, vin chc ngnh y t, nhn vin y t thn bn, cng tc vin dn s c thc hin ng theo quy nh, m bo i ngi cn b y t yn tm cng tc vi ngnh. - Thc hin c hiu qu ngun ngn sch cp cho cng tc bo v, chm sc v nng cao sc khe nhn dn huyn. Kinh ph u t cho cng tc bo v, chm sc v nng cao sc khe nhn dn huyn tng dn hng nm. Thc hin tt cc chnh sch h tr ngi ngho, ngi c cng vi cch mng, cc i tng chnh sch x hi, tr em di 6 tui gim gnh nng chi ph y t thng qua hnh thc tham gia BHYT. II. Nhng mt lm c, hn ch yu km v nguyn nhn: 1. Nhng mt lm c: - Cng vi s quan tm lnh o, ch o ca S Y t, cc cp u ng, chnh quyn v on th, s tham gia phi hp lin ngnh trong cng tc chm sc bo v sc kho nhn dn. Nhng nhim v trng tm ca cng tc bo v, chm sc sc kho nhn dn  t c nhiu kt qu quan trng, mt s ch tiu vt mc k hoch  ra. - H thng y t c s c i mi nh c s u t kinh ph cho vic xy dng, nng cp c s h tng v mua sm trang thit b y t. Trm Y t x, th trn hot ng c hiu qu gp phn quan trng trong cng tc chm sc sc khe ban u cho ngi bnh. - C cu i ngi cn b y t tng bc p ng yu cu, t l cn b y t c trnh  i hc v sau i hc ngy mt cao. - Cc chng trnh mc tiu quc gia c trin khai c hiu qu, kp thi khng ch dch bnh, bo v v nng cao th trng, tui th ca nhn dn, gp phn quan trng vo s nghip pht trin kinh t - x hi ca huyn. 2. Nhng kh khn, hn ch - S bin i ca mi trng ko theo dch bnh mi pht sinh, c din bin phc tp. - Mt s a phng cha pht huy c ht cng sut s dng ca trang thit b hin c, cha p ng kp thi nhu cu khm cha bnh ca nhn dn. - Cng tc qun l nh nc v y t trong l)nh vc VSATTP, cng tc vn ng ngi dn tham gia bo him y t  mt s x- TT cn gp nhiu kh khn. - C s vt cht, trang thit b v nhn lc y t tuy  c u t, cng c thng xuyn nhng bt cp cha ng b, tng thi im cn thiu BS chuyn khoa su ( BS gy m, BS VLTL& ). - PKKKV hot ng theo Thng t s 15-BYT/TT ngy 17/5/1977 ca B Y t hngs dn t chc phng khm bnh a khoa khu vcj theo Ngh quyt s 15-CP ca Hi ng Chnh ph khng thc hin iu tr ngi bnh ni tr nh hng n hot ng ca PKKKV v nh hng chung n ton Trung tm. - Ch  ph cp cho nhn vin y t thn ti 02 th trn Nam Ban, inh Vn cha m bo. 3. Nguyn nhn - Mt s cp y ng, Chnh quyn a phng cha tp trung lnh o, ch o t chc thc hin cc quan im, mc tiu v nhim v  ra, cng tc phi hp vi ngnh y t cha cht ch, hiu qu. - M hnh t chc h thng y t cha n nh, thiu cn b lm cng tc qun l nh nc v y t, cn tnh trng chng cho chc nng nhim v gia cc c quan n v, trin khai cng tc qun l nh nc v y t trong l)nh vc VSATTP theo vn bn mi cn chm, cha r rng, x hi ha m ca gy kh khn cho cng tc kim sot cht lng ATTP, tnh trng nhim thc phm. - Cng tc d bo s pht trin ca ngnh ti n v cn hn ch, o to ngun nhn lc cha kp thi vi nhu cu CSSK ti a phng. - Do nh hng ca tnh hnh suy thoi kinh t chung  hn ch ngun kinh ph u t cho s nghip y t trn a bn huyn. - Cn mt b phn cn b y t cha thc s ch trng, chuyn tm n cng tc hc tp nng cao trnh  chuyn mn nghip v  p ng vi tc  pht trin ngy cng cao ca x hi. PHN TH HAI K hoch pht trin cng tc y t giai on 2021-2023 I. Cn c xy dng k hoch Cn c Thng t s 38/2019/TT-BTC ngy 14 thng 8 nm 2019 ca B Ti chnh hng dn xy dng d ton ngn sch nh nc nm 2020, k hoch ti chnh 3 nm 2020-2022; k hoch ti chnh 5 nm tnh, thnh ph trc thuc Trung ng giai on 2021-2025; Cn c cng vn s 3033/BYT-KHTC ngy 02 thng 6 nm 2020 ca B Y t v/v xy dng k hoch v bo m kinh ph thc hin cc nhim v chi  c b tr t ngn sch CTMT Y t- Dn s cho giai on 2021-2025; Cn c K hoch s 540/KH-SYT ngy 15/5/2020 ca S Y t Lm ng v pht trin s nghip y t giai on 2021-2025, Cn c cng vn s 1599/SYT-KHTC ngy 02/7/2020 ca S Y t v/v: hng dn lp k hoch cng tc y t v d ton ngn sch nh nc 2020 v giai on 2021-2023. II. Quan im, mc tiu pht trin y t c s: 1. Quan im: - Sc khe l vn qu nht ca mi con ngi v ca ton x hi; bo v, chm sc v nng cao sc khe nhn dn l bn phn ca mi ngi dn, mi gia nh v cng ng; l trch nhim ca cc cp y ng, chnh quyn, cc ban ngnh, on th, t chc chnh tr - x hi, trong  ngnh y t gi vai tr nng ct v chuyn mn k thut. - Nng cao kh nng p ng ca ngnh y t huyn Lm H ph hp vi nhu cu chm sc sc kho ca nhn dn v gp phn pht trin kinh t - x hi. - Tng bc nng cao cht lng dch v y t; tng kh nng tip cn ca ngi dn i vi cc dch v y t, gp phn gim t l mc bnh v di chng. - Nng cao ch s sc kho, tng tui th, n nh quy m v nng cao cht lng dn s. - Thc hin bo him y t ton dn, tng bc m bo quyn cng bng trong chm sc sc khe ca nhn dn. 2. Mc tiu tng qut: 1. Cht lng cng tc khm cha bnh phc v bnh nhn tip tc c nng cao. Cc ch s thu dung iu tr bnh nhn ti cc c s y t u t v vt so vi ch tiu k hoch. 2. m bo cc bin php phng chng dch c trin khai thng xuyn, kp thi v c hiu qu, p ng c tnh hnh din bin phc tp ca dch bnh, phn u khng  ng c thc phm, dch bnh ln xy ra v gim s mc bnh truyn nhim trong nhm bnh  trin khai tim phng vacxin phng bnh trong d n TCMR. 3. Tip tc gim t l tai bin sn khoa v t l suy dinh dng tr em < 5 tui, phn u t l tr em b suy dinh dng cn nng cn <10,35%, th thp ci cn 15,95% . 4. Cht lng cc hot ng ca TYT x c cng c v nng cao, phn u 100% x t danh hiu x t B tiu ch Quc gia v Y t giai on n mi. 5. Hng nm ng b, cc t chc on th, chnh quyn u hon thnh tt nhim v tr ln, n v t danh hiu c quan vn ha. 3. Cc ch tiu c th: * Ch s ngun nhn lc: Tng s lao ng nm 2023 l 300, tng 4,5 % trong : - Tuyn huyn ( iu tr + d phng): 143 lao ng - H x + dn s: 137 : (117 + 20 DS). - Hp ng theo N 161: 20 Nhu cu pht trin ngun nhn lc: TTTrnh  chuyn mnNhu cu (Hin c + T thm)o to t i ngi CBVCTuyn dng thm1Sau i hc :-BS chuyn khoa II42-BS chuyn khoa I2510 ( Ni, Nhi, Ngoi TQ, TMH, PHCN, Mt, Sn, YHCT, GMHS, CHA-Thc s) Y 62-Thc s) khc 31-BS chuyn khoa s b83 ( SKTT, PHCN, TMH,) 2i hc :-BS a khoa358 ( thm 3)-C nhn NHS95-C nhn iu dng175 ( xem li)-C nhn y t cng cng1918 ( xem li-C nhn XN44 ( xem li)-Dc s i hc41-C nhn k ton 42 ( xem li)- Cao ng NHS2013 ( xem li)- Cao ng D29223Chnh tr, qun l nh ncQun l nh nc ngch chuyn vin3413Qun l nh nc ngch chuyn vin chnh52Trung cp l lun chnh trXem li2Cao cp l lun chnh tr42* Ch s y t d phng - Gim t l mc st rt, khng  t vong do st rt. - 96% tr em < 1 tui c tim chng y  cc loi vacxin ca d n TCMR. - 90% c s KD, SX, BB thc phm c a ch n nh t tiu chun ATVSTP. - Qun l v iu tr 100% BN lao c pht hin; qun l trn 95% bnh nhn tm thn; qun l v chm sc 100% bnh nhn phong. - Qun l bnh khng ly nhim > 50% * Dn s v pht trin - Gim s tai bin sn khoa. - Gim t l sinh con th 3 tr ln ( c bit l sinh con th 3 tr ln ngoi mun). - T l tr em < 5 tui b SDD < 10,35% , SDD th thp ci cn < 15,95% - T xut t vong tr em <5 tui t 15,30 v t xut t vong tr em < 1 tui 8,50 . * Ch tiu v khm bnh, cha bnh: - Phn u trn 90% dn s c qun l sc khe;100% Trm Y t x, th trn thc hin tt d phng, qun l, iu tr hiu qu bnh khng ly nhim. - t 16 ging bnh, 4.5 bc s), 0,41 dc s) i hc, 13 iu dng vin trn 10.000 dn. T l hi lng ca ngi dn vi dch v y t t trn 85%. - 100% Trm Y t thc hin c ti thiu 80% danh mc k thut c cp c thm quyn ph duyt - 100% Phng khm a khoa khu vc thc hin ti thiu 85% danh mc k thut c cp c thm quyn ph duyt. - Bnh vin huyn thc hin c ti thiu 80% danh mc k thut c cp c thm quyn ph duyt. - Trin khai k thut mi hng nm: t 1 n 3 k thut/ nm - Duy tr 100% x gi vng tiu ch x t b tiu ch quc gia v y t x. - Nng cao nng lc qun l cht lng bnh vin. III. CC NHIM V V GII PHP THC HIN 3.1. Cng c, hon thin t chc mng li y t c s a) T chc Trung tm Y t huyn: bao gm cc Phng khm a khoa khu vc, Trm Y t, khu iu tr trung tm 110 gng bnh c 12 khoa ( tng 02 khoa HSTC, phng chng nhim khun) theo quy nh ti Thng t s HYPERLINK "https://thuvienphapluat.vn/phap-luat/tim-van-ban.aspx?keyword=37/2016/TT-BYT&area=2&type=0&match=False&vc=True&lan=1" \t "_blank" 37/2016/TT-BYTngy 25/10/2016 ca B Y t v vic hng dn chc nng, nhim v, quyn hn v c cu t chc ca Trung tm Y t huyn, qun, th x, thnh ph thuc tnh, thnh ph thuc thnh ph trc thuc Trung ng. Thc hin y  cc chc nng v y t d phng, khm bnh, cha bnh, phc hi chc nng; cc Phng khm a khoa khu vc v Trm Y t x - th trn l n v chuyn mn thuc Trung tm Y t. - R sot li t chc cc Phng khm a khoa v chc nng nhim v v kh nng p ng, cung ng dch v chm sc sc khe ban u cho nhn dn. - Nhn lc lm vic ti cc Trm Y t x - th trn nm trong tng bin ch ca Trung tm Y t huyn c xc nh theo v tr vic lm trn c s khi lng cng vic ph hp. b) Thc hin phn loi cc Trm Y t theo B Tiu ch quc gia v y t x  thc hin cng tc u t, c ch hot ng cho ph hp. - R sot li phn loi Trm Y t theo quy nh ti Quyt nh HYPERLINK "https://thuvienphapluat.vn/phap-luat/tim-van-ban.aspx?keyword=4667/Q%C4%90-BYT&area=2&type=0&match=False&vc=True&lan=1" \t "_blank" 4667/Q-BYTngy 07/11/2014 ca B Y t v vic ban hnh b tiu ch quc gia v y t x giai on n 2020. - R sot c s vt cht, trang thit b Trm Y t; thu ht u t bng mi ngun lc  nng cao nng lc chm sc sc khe ban u cho nhn dn. 3.2. i mi, nng cao hiu qu hot ng ca tuyn y t c s: a) Cc Trm Y t x phi thc hin y  cc nhim v ca chm sc sc khe ban u; thc hin vic lp h s qun l sc khe in t ton din, lin tc cho tng ngi dn trn a bn, tp trung vo vic theo di, t vn v sc khe, chm sc gim nh, phc hi chc nng, chm sc sc khe ngi cao tui, b m, tr em; phng chng cc bnh ly nhim, khng ly nhim, qun l cc bnh mn tnh; khm bnh, cha bnh theo chc nng, nhim v v kt ni, chuyn ngi bnh ln cc c s y t tuyn trn. b) Phng khm a khoa khu vc thuc cc Trung tm Y t tip tc nng cao trnh  chuyn mn, pht trin cc dch v, k thut y t, bao gm c l)nh vc xt nghim, cn lm sng bo m thun li, ph hp  thc hin y  cc k thut iu tr a khoa v chm sc c bn, thng xuyn ch o, h tr trc tip v chuyn mn, gn kt cht ch hot ng ca Phng khm a khoa khu vc v cc Trm Y t. c) Xy dng v thc hin c ch phi hp hot ng gia cc c s y t cng lp v ngoi cng lp trn a bn, c c ch khuyn khch y t t nhn tham gia vo cng tc chm sc sc khe ban u. d) Thc hin tin hc ha cc hot ng ca y t c s v qun l h s theo di sc khe ca tng ngi dn. ng b v kt ni h thng thng tin gia c s y t cc tuyn  theo di, qun l sc khe ngi dn trn a bn; qun l hot ng khm, cha bnh v chi ph khm, cha bnh bo him y t ti cc c s y t trn a bn. ) Cc c s y t tch cc tham gia cc hot ng truyn thng nng cao nhn thc, thay i hnh vi ca ngi dn  bo v, chm sc v nng cao sc khe, cc hot ng v y t d phng, chm sc sc khe ban u. e) Trin khai m hnh hot ng theo nguyn l y hc gia nh. 3.3. Tng cng o to v nng cao cht lng ngun nhn lc: a) Tip tc tng cng ngun nhn lc, c bit l s lng bc s  Trung tm y t huyn  bo m nhn lc cho vic khm bnh, cha bnh phc v nhn dn ngay trn a bn; bo m nhn lc cho Trm y t  thc hin chm sc sc khe ban u, theo di sc khe tng ngi dn. b) Thu ht ngun nhn lc y t theo mi hnh thc  p ng nhu cu nhn lc cho y t c s p ng theo qui nh theo thng t 08/2007/TTLT-BYT-BNV ngy 05 thng 6 nm 2007 hng dn nh mc bin ch s nghip trong cc c s y t nh nc. - Xy dng c ch thu ht bc s v cng tc ti tuyn y t c s. - Tng cng o to bc s cho y t x - th trn: o to lin thng, phn u 3 TYT c 2 BS hot ng thng xuyn. - Tng cng o to nhn vin y t thn, bn v c  thn, bn. c) Thc hin ch  lun phin hai chiu ph hp vi iu kin ca tng a phng theo hng t trn xung di v t di ln trn  tng cng nng lc cho ngi hnh ngh ti y t c s. 3.4. i mi c ch ti chnh cho hot ng ca y t c s: a) y nhanh l trnh bo him y t ton dn: - Tham mu h tr i vi ngi thuc h cn ngho, ngi thuc h nng nghip, lm nghip, ng nghip c mc sng trung bnh tham gia bo him y t. - Trm y t x c trch nhim tham gia tuyn truyn, vn ng nhn dn tham gia bo him y t theo hng dn ca B Y t v Bo him X hi Vit Nam. b) T chc khm bnh, cha bnh v cc dch v y t thanh ton bo him y t i vi phng khm bc s gia nh: - Khm bnh ti nh cho mt s trng hp v i tng c bit. - Khm v t vn sc khe. - Cc t khm bnh, cha bnh lu ng ca Trm y t x, Trung tm y t huyn, bnh vin huyn ti thn, bn theo nh k. c) Thc hin t chc gi dch v y t c bn cho y t c s.  m bo p ng nhu cu chm sc sc khe ca ngi dn, trong  xc nh r phn do Qu bo him y t chi tr. Thc hin thanh ton theo nh sut i vi khm bnh, cha bnh ngoi tr ti y t c s. d) Thc hin gi dch v khm bnh, cha bnh theo l trnh tnh  chi ph cho y t c s. T chc phn loi, giao quyn t ch cho cc c s Y t thuc tuyn Y t c s. Ngn sch nh nc h tr i vi cc trung tm c c quan c thm quyn phn loi l n v t bo m mt phn chi thng xuyn, n v do Nh nc bo m chi thng xuyn. ) Thc hin nh mc chi ngn sch nh nc cho y t d phng tuyn huyn. - Bo m  tin lng v cc ch , chnh sch cho vin chc y t c s, ph cp cho nhn vin y t thn, bn. - Xy dng v ban hnh mc chi thng xuyn ngoi lng  bo m kinh ph cho cc hot ng thng xuyn, hot ng chm sc sc khe ban u ca Trm y t x. - Phn b ngn sch nh nc, s dng qu bo him y t v cc ngun lc khc cho y t c s theo hng da trn kt qu hot ng v cc ch tiu u ra. e) T chc thc hin s gn kt gia y t t nhn v y t cng lp trong cung ng cc dch v chm sc sc khe ban u trn a bn. Cho php cc Trm y t x lin doanh, lin kt vi cc doanh nghip, c nhn thc hin vic khm, cha bnh cho nhn dn. 3.5. u t  hon thin, nng cao nng lc h thng y t c s - B tr ngn sch tnh, ngn sch huyn v cc ngun kinh ph hp php khc  tip tc u t c s vt cht ca Trung tm Y t, Phng khm a khoa khu vc, Trm Y t nhm hon thin h thng y t c s ca huyn. - i vi trm y t x: trong giai on t nay n nm 2025 b tr ngn sch tnh, huyn, x  u t c s vt cht cho cc trm y t x, th trn xung cp cn phi xy dng mi hoc ci to, nng cp; Vic u t xy dng mi, ci to m rng, nng cp cc trm y t x phi theo thit k, quy m ph hp vi phn vng Trm Y t v theo nhu cu thc t  a phng, bo m tit kim, trnh lng ph. 3.6. y mnh cng tc x hi ha y t: - i mi v tng cng s lnh o, ch o ca cc cp u ng, chnh quyn, s phi hp lin ngnh ca cc ban, ngnh, MTTQ v on th cc cp. Vn ng nhn dn tham gia gim st thc hin ch trng, chnh sch ca ng v Nh nc v cng tc bo v, chm sc v nng cao sc kho nhn dn. - Thc hin x hi ha cc dch v y t, to iu kin cho cc c s y t ngoi cng lp pht trin v c quy m v cht lng theo quy nh ca php lut. - Thc hin c hiu qu XHH dch v y t ti TTYT, PKKKV v cc TYT x-TT. 3.7. Nng cao hiu qu qun l nh nc: - Phi hp vi Phng Y t tham mu UBND huyn qun l tt v an ton v sinh thc phm v hnh ngh y dc t nhn. - Thc hin tt nhim v chuyn mn theo qui nh, ng vin CBVC thc hin tt qui nh php lut, c bit hnh ngh y dc t nhn. IV. K HOCH U T CHO Y T C S GIAI ON 2021-2023 4.1. u t nng cp c s vt cht: 4.1.1. Xy dng mi - Giai on t 2021-2023 xy dng mi Phn trm y t Ph Sn, M Linh, nh khoa Khm bnh v Khoa Ni- Nhim, nh n cho BN, h thng cht thi rn y t vi tng kinh ph: 21 t ng. 4.1.2. Ci to nng cp: - Giai on t 2021-2023 nng cp mt s n v: TYT ng Thanh, inh Vn, Ph Sn, an phng, Lin H, Phng khm Nam Ban, nh Hp sy, nh i th tng kinh ph d kin khong 5,6 t ng. 4.2 Kinh ph hot ng: V. KIN NGH,  XUT 5.1. i vi S Y t: - Nghin cu u t pht trin Trung tm Y t huyn Lm H p ng yu cu khm, cha bnh cho nhn dn v gp phn gim ti p lc cho bnh vin tuyn trn. - u tin phn b cc bc s thuc cc  n o to ngun nhn lc cht lng cao ca tnh, o to theo a ch  gp phn nng cao s lng v cht lng ca i ngi lm cng tc y t ti TTYT huyn. - Cho php cn i ngn sch tnh hng nm  b tr phc v cho cng tc o to nhn lc ngnh y t trn a bn huyn. 5.2. i vi UBND huyn: - Thng xuyn ch o h thng chnh tr tch cc thc hin cc gii php  nng cao cng tc bo v, chm sc v nng cao sc kho nhn dn trong tnh hnh mi. Giao nhim v cho cc t chc trong h thng chnh tr ca huyn, coi y l mt ni dung quan trng trong vic nh gi tnh hnh thc hin nhim v hng nm. - Tip tc  ngh UBMTTQ, cc on th, cc ban, ngnh lin quan trn c s nhim v chnh tr hng nm a chng trnh mc tiu v y t l mt ni dung thng xuyn lin tc ca n v. - Tranh th cc ngun vn, c bit h tr ca Thnh Ph H Ni u t c s vt. PHN TH BA T CHC THC HIN Phn cng trch nhim ca cc n v  t chc thc hin 1. Phng KH-NV: - Tham mu t chc trin khai thc hin k hoch xy dng v pht trin mng li y t c s trong tnh hnh mi trn a bn huyn. Xy dng, trin khai k hoch xy dng v pht trin mng li y t c s hng nm ca huyn, x trong tnh hnh mi cho ph hp vi k hoch pht trin kinh t - x hi ca a phng trong cng thi k. - Thng xuyn kim tra vic thc hin k hoch ti cc n v; thc hin ch  bo co hng nm vic thc hin k hoch trn a bn theo quy nh hin hnh. - Trin khai nh gi tin  thc hin k hoch qua tng giai on ca k hoch. - Thc hin cng tc thng k bo co y , khoa hc; trn c s cc s liu thu thp ca nm trc, tham mu xy dng k hoch hot ng hng nm ph hp vi tnh hnh thc t ca n v v trn c s ca k hoch ny. - Hng nm tham mu xy dng k hoch, thc y cng tc nghin cu khoa hc, gii php hu ch,  xut p dng kt qu NCKH vo thc tin khm cha bnh phm vi ton trung tm nhm nng cao cht lng khm cha bnh. - Hng nm tham mu xy dng k hoch y mnh cng tc ch o tuyn, lun phin cn b, chuyn giao k thut theo  n 1816 ph hp vi tng n v . - Hng nm tham mu xy dng k hoch kim tra gim st, chn chnh cng tc chuyn mn, thc hin k hoch ca cc n v. - Hng nm hi ng qun l cht lng bnh vin tham mu xy dng k hoch ci tin cht lng bnh vin. 2. Phng TC-HC: - Ch ng  xut trong cng tc o to cn b v sp xp v tr vic lm ph hp vi tng chc danh ngh nghip, nng cao cht lng ngun nhn lc. - Tham mu sa cha, b sung c s vt cht, trang thit b cn thiu. - Xy dng chng trnh o to lin tc v xin cp m o to  m bo cho cng tc o to lin tc ti n v. 3. Phng TC- KT: - Ch ng, tch cc huy ng ngun lc  thc hin k hoch; lng ghp vic thc hin c hiu qu k hoch ny vi cc k hoch khc c lin quan trn a bn. - Xy dng k hoch ti chnh m bo cho hot ng ti n v. - m bo thu chi ngn sch - Thc hin m bo ch  lng v ph cp cho nhn vin y t. 4. Cc khoa, TYT: - S dng, qun l c hiu qu c s vt cht- Trang thit b  c giao, nh k  ngh duy tu bo dng, mua sm. - Xy dng v trin khai k hoch c th hng nm phn u t ch tiu k hoch c giao. Trn y l k hoch Pht trin cng tc y t Giai on 2021-2023 ca Trung tm Y t huyn Lm H, rt mong c s quan tm ch o su st ca S Y t, huyn u  UBND huyn, s phi kt hp c hiu qu cc ban ngnh on th, chnh quyn cc a phng  TTYT Lm H hon thnh nhim v chnh tr c giao vi hiu qu cao nht . 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