ࡱ> OQJKLMN_ bjbj 4bbi+ WWWWWkkk8Dtk3[#[#q#q#q#$l%4%32525252525252$P69Y2W&$"$&&Y2WWq#q#Ov3Q*Q*Q*&Wq#Wq#32Q*&32Q*Q*V0@_1q#n.^&"0 2303 1T9&(9_19W_1%"%Q*% &%%%Y2Y2)d%%%3&&&&9%%%%%%%%% ! :  S Y T LM NG CNG HO X HI CH NGH(A VIT NAM TRUNG TM Y T LM H c lp  T do  Hnh phc  S : /KH  TTYT Lm H , ngy thng 7 nm 2020 K HOCH CNG TC NM 2021 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. Cn c vo kt qu thc hin ch tiu k hoch 6 thng u nm, c tnh c nm 2020 v d bo tnh hnh pht trin kinh t  x hi ca a phng trong nm 2021. Trung tm Y t Lm H xy dng k hoch hot ng nm 2021 vi nhng ni dung c th nh sau: PHN TH NHT TNH HNH THC HIN K HOCH NM 2020 1. Cc k hoch  ph duyt: 1.1. K hoch hot ng chuyn mn: Cng tc khm cha bnh, phng chng dch, CSSKSS: s 143/KH-TTYT ngy 30/7/2019. 1.2.  n tinh gin bin ch ca n v 147/A-TTYT ngy 29/7/2015 ca Trung tm Y t Lm H;  n tinh gin bin ch b sung sa i: 171/A-TTYT ngy 06/5/2019. 1.3. T trnh s 105/TTr-TTYT ngy 05/12/2019 ca Trung tm Y t Lm H v vic xin ph duyt k hoch o to nm 2020. Bo co s 154/BC-TTYT ngy 3/12/2019 ca Trung tm Y t Lm H v vic bo co cng tc o to bi dng CB, CC, VC 2019 k hoch o to 2020. Cng vn s 268/SYT-TCCB ngy 13/2/2020 ca S y t Lm ng v vic ph duyt k hoch o to nm 2020 1.4. K hoch trin khai  n 1816: s 145/KH-TTYT ngy 05/8/2019. 1.5. Thc hin quyt nh s 1386/Q-UBND ca UBND t)nh Lm ng v vic sp nhp TTDS vo TTYT huyn. 2. Nhng ni dung  trin khai: 2.1. K hoch hot ng chuyn mn: - Trin khai cng tc khm bnh, cha bnh, thng trc cp cu, phc hi chc nng t TTYT n cc PK KKV v TYT x- Th trn. - Trin khai cng tc phng chng dch, chng trnh y t - dn s, m bo ATTP: khng  dch bnh v cc v ng c ln xy ra 16/16 x  th trn. 2.2. K hoch o to: -  trin khai cng tc o to di hn, ngn hn theo k hoch, hin ang o to: l 47, trong  02 sau i hc (ang o to: 01; mi c i hc 01); i hc 14, o to chuyn mn ngn hn v khc 31. 2.3. K hoch trin khai  n 1816: - 6 thng u nm ch thc hin  n 1816 ti TYT an Phng v hng dn siu m tng qut v siu m thai, cn mt s TYT cha trin khai c do thiu cn b, c 6 thng cui nm trin khai thc hin mt s hot ng chnh theo k hoch.. 2.4. K hoch tinh gin bin ch: -  trin khai theo tinh thn ch o ca cp trn: Tinh gin 2 ngi t 66,7% KH. 2.5. K hoch trin khai p dng k thut mi: - Cha hon thnh tin  k hoch  ra do cha  iu kin, d kin trong 6 thng cui nm s thc hin c mt s k thut theo k hoch. 3. Tng hp cc ngun ngn sch: - Trung ng h tr: 0 (t l %: Trung ng/ a phng/ Tng mc u t) - a phng cp hot ng n v: 27,812,282 - Vn vay, vin tr ( ngn hng pht trin ADP): 0 - Ngun ngn sch tnh (s s kin thit) cp cho xy dng: 0  4. Kt qu t c: (6 thng 2020) TTCc ch tiuCh tiuThc hin 6 thngSS ch tiu nm 2020SS cng k nm 2019c c nm 2020I.T chc cn b CSVT1Tng s ngi lao ng 267287107,9%! 1,3%2801.1Tuyn huyn 150156104%!14,2%1511.2Tuyn YTCS117131111,9%! 11,9%129II.Cng tc KCB1Tng s ging bnh1.1- Bnh vin 110110100%=100%1.2- 2 PKKKV ging lu1212100%=100%2Ch tiu chuyn mn2.1TS ln khm bnh240.000101.83642,4%!3,9%228.0002.2Ngy iu tr ni tr 40.15011.48528,6%!8,6%34.1272.3iu tr ngoi tr 1.90080342,3%!1,1%1.7482.4Ngy T TB/BN53.672%!23%4,22.5Phu thut 46014832,2%!15,6%390IIIHOT NG CLS1TS Ln XN 66.88036.34054,3%!3,9%66.8802TS chp XQ 30.00012.93143,1%!5,6%28.5003TS siu m 21.4009.74545,5%!9,4%20.3304TS in tim2.0001.07153,6%!11%2.0005Ni soi95035737,6%!1,2%807IVPHNG CHNG SR 1- Lam XNKSTSR 8000390948.9%!(80002- S mc SR 200!1 ca0VTCMR-LTUVSS1TE < 1 tui tim y  >95%44.8%44.8%((0%>95%2PNCT tim VAT2 95%45.6%44.8%(0.3%>95%VICSSKSS- PCSDD1T l qun l thai97%99,5%102,6%!0,9%97%2T l PN  c khm thai > 3 ln 96%94,9%98,9%!2,9%96%3T l PN  v tr SS c chm sc sau sinh ti nh8492,9%110,6%!2,4%84%4T l PN  c nhn vin y t 99%100%101%=99%5T sut t vong <1 tui8.50 4.20 49.4%!0,88.56T sut t vong <5 tui15.30 9.550 62,4%!1,4515.37TS ln khm PK11.350340630%!5,775008TS ngi iu tr PK4.700161634,4%!9,235009T l TE< 5 tui SDD 0,1%10,95>100%=10,95%VIID n PC.HIV/AIDS 1T l CBYT x v YTTB c tp hun95%95%100%Khng !! 100%2.T l x t chc m hnh / hot ng TT100%100%100%Khng !! 100%3Mu gim st HIV3000142047%! 2% 100%4S lt NBD c TC/////5T l ngi NCMT c tip cn855058%!8% 100%6T l PNCT c XN95%128451!1% 100%7T l BN lao c XN100%24100%Khng !! 100%VIIID n PC LAO 1S BN mi pht hin 201155%Khng !!100%2S lam m XN58524341.5%(0.5%85%IXChng trnh DS v pht trin1 Mc gim sinh0,03Khng !!0,032 T l tng dn s t nhin1,10 001.13T s gii tnh khi sinh (trai/100 gi)106121114 !11,21084T l sng lc trc sinh41%31,6%77% =65%5T l sng lc s sinh51%3,4%6,7%!0,5%24%6S ngi thc hin cc bin php trnh thai hin i trong nm19.47519.475100% =19.475*Cng tc o to cn b : ( lu KH o to 2020 = KH o to c duyt nm 2020 + s ang o to) TT Hnh thc o toK hoch nm 2020Thc hin 6 thngc c nmSo snh ch tiu KHTng sDuyt 2020Io to di hn44338301BS chuyn khoa II1111100%2BS chuyn khoa I420250%3Thc s1101100%4 BS o to CM1101100%5 BS chuyn tu43236CN iu dng37CN YTCC8CN HS31119 Dc s i hc422250%10C iu dng202001785%11CN CHA0112CN XN 2222II o to ngn hn3331Siu m tng qut2202100%2o to khc1101100% Tng (I + II)4736825 * Qun l ti chnh nm 2020 (n v ng VN) n v tnh : VT: 1.000 ngSTTNi dung D ton giao ( K hoch )Thc hin 6 thngSo snh ch tiu KHc c nm 2020AD TON THU62,279,28224,805,16440%57,651,914INgun NSNN cp27,812,2829,885,34836%27,812,282 - Thng xuyn22,315,2229,586,93843%22,315,222 - Khng thng xuyn5,497,060298,4105%5,497,060IINgun thu di#ch vu# KCB, YC trong :34,467,00014,919,81643%29,839,632 - Thu BN khng co the  2,096,6584,193,316 - Thu BHYT12,245,60324,491,207- Thu dch v theo yu cu577,5551,155,109 - Thu khcBD TON CHI60,259,92224,128,50440%55,703,550ID ton chi hot ng thng xuyn22,314,8629,586,93843%22,314,8621H iu Tr2,092,455481,64523%2,092,4552H X13,744,3336,099,83344%13,744,3333H D phng2,664,0101,256,14247%2,664,0104Ph cp nhn vin y t thn bn1,305,240648,89550%1,305,2405H# Dn s2,508,8241,100,42344%2,508,824IID ton chi khng thng xuyn 3,478,060298,4109%3,478,0601H iu Tr45,76000%45,7602H X184,50094,86651%184,5003H D phng3,174,000203,5446%3,174,0004H Dn s73,80000%73,800IIID ton chi t thu di#ch vu#34,467,00014,243,15641%29,910,6281Chi mua thuc, VT, HC, hot ng, sa cha7,253,29515,231,9192Chi con ngi6,989,86114,678,7094.1. Cng tc cn b: - Hin ti ang thc hin theo Quyt nh s 173/Q-SYT ngy 28/6/2012 ca S Y t Lm ng v vic kin ton c cu t chc ca Trung tm Y t huyn Lm H v quyt nh s 386/Q-UBND ca UBND tnh Lm ng v vic st nhp TTDS v TTYT huyn, thm 01 b phn Dn s v 20 bin ch so vi bin ch giao u nm 2019. n v  tham mu chun b trin khai thc hin theo Thng t 37/2016/TT-BYT ngy 25 thng 10 nm 2016 ca B Y t, s kin ton b my cc khoa phng, b phn, khu iu tr trung tm c 10 khoa (Ni - Nhim ; YHCT-PHCN; Nhi; khoa Khm bnh- Hi sc tch cc chng c; Chm sc sc khe sinh sn; Ngoi  LCK; Dc- TTB-VTYT; khoa Cn lm sng-CHA; khoa Kim sot bnh tt v HIV/AIDS, Khoa Y t cng cng v Dinh dng); 05 phng chc nng; 02 phng khm a khoa khu vc; 16 TYT x  TT (c 03 phn trm y t  cc x Tn Thanh, M Linh, Ph Sn). * Thc hin ch tiu bin ch S Y t giao: - S ngi lao ng trong n v n 30/6 l 287 CBYT, c thc hin c nm 280; so vi ch tiu lao ng c giao 2020 t 104,9% KH. - Vic b tr sp xp nhn lc ti cc khoa phng, TYT x ph hp vi trnh  chuyn mn, nng lc cng tc. -  r sot li  n v tr vic lm, thc hin k hoch thi tuyn vin chc nm 2020 cho 18 v tr vic lm t 100%. - Trong 6 thng u nm ngh ch  06 ( trong  02 ngi ngh hu trc thi hn), d kin c nm ngh ch  8 ngi. 4.2. Cng tc o to: - 6 thng u nm 2020 c 8 /44 ngi c o to t 18,2% KH , c c nm: 30/33 t 90,9% KH , chim 10,5 % s lao ng. 4.3. Cng tc chuyn mn 4.3.1.Cng tc phng chng dch, thc hin cc chng trnh mc tiu: - Cng tc phng chng dch: - 6 thng u nm tnh hnh dch bnh COVID-19 din bin phc tp. Ngay khi c cc Ch th, Cng in, Quyt nh, k hoch ch o ca Th tng Chnh ph, ca BYT, UBND tnh Lm ng, S Y t v vic ch o trin khai cc hot ng phng chng dch COVID-19.  phi hp tham mu BG, UBND huyn Lm H ban hnh cc cng vn, k hoch, quyt nh, ch o cc Ban, ngnh, on th trin khai y  cc vn bn v phng chng dch COVID-19 trn a bn huyn Lm H y , kp thi. + Ch o cc Trm Y t gim st thng xuyn nhn dn trn a bn c bit lu ngi dn tng i qua cc vng c dch trong nc; + Phi hp vi cng an huyn qun l cc nh xe khch Bc-Nam  theo di tnh trng sc khe ca hnh khch. + Tng s trng hp cch ly ti nh n ngy 30/6/2020 l 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. 4.3.2. D n phng, chng mt s bnh truyn nhim nguy him v cc bnh khng ly nhim ph bin. - Phng, chng lao: Trong 6 thng khm pht hin: 274 bnh nhn, trong  xt nghim pht hin 243/585 t 41,5% k hoch nm [pht hin 11 lam (+)]. Hin ti qun l iu tr cho 55 bnh nhn. - Phng, chng phong: Duy tr vic khm bnh da ti phng khm da liu, khm lng ghp bnh da ti cc TYT x, TT. Tng s BN qun l: 04 BN, trong  sn sc tn tt: 04 bnh nhn. - Phng, chng st rt: trong 6 thng: Lam, que th xt nghim: 3909/8000 t 48,9%; KSTSR: 00, BNSR: 0. Tnh hnh st rt trn a bn ton huyn so vi 6 thng nm 2019 s bnh nhn St rt gim 01 ca; - Phng, chng st xut huyt: Tnh hnh St xut huyt n 6 thng: Pht hin 10 ca gim 04 ca so vi 6 thng/2019.  c gim st dch t v x l mi trng theo qui nh. - Bo v sc khe tm thn: Trong 6 thng khm pht hin 120 lt BN, thu dung mi 03 bnh nhn. Hin qun l s BN tm thn, iu tr: 435 BN, trong  (Bnh TTPL: 194 BN, bnh K: 241 BN). - Phng, chng ung th: Trin khai thc hin cng tc truyn thng  nng cao nhn thc ng ca cng ng v phng chng v pht hin sm bnh ung th. S bnh nhn tch liy: 322 BN. Qun l hin ti cn sng ca n v: 236 BN, trong  c mt s loi ung th c t l mc cao nh: K gan, K phi 40 ca. - Hot ng phng chng bnh tim mch: Tip tc tuyn truyn, gio dc sc khe, phng chng tng huyt p cho ngi dn, qua  nng cao nhn thc d phng, pht hin sm, iu tr kp thi bnh tng huyt p. Tng s bnh nhn THA qun l: 4.617 bnh nhn, trong  s bnh nhn huyt p bin c: 32 BN, s BN THA chuyn tuyn: 03 - Hot ng phng, chng bnh phi tc nghn mn tnh v Hen ph qun: Duy tr cc hot ng phng chng bnh phi tc nghn mn tnh v hen ph qun ti huyn theo quy nh. Tng s bnh nhn qun l: 138, trong : Bnh phi tc nghn mn tnh: 58 ngi, hen ph qun: 80 ngi 4.3.3. D n tim chng m rng: + Tr em TC t 44,8% KH (1075/2402) khng tng, khng gim so vi cng k 2019; Trong 6 thng do tnh hnh dch bnh nn c 1 thng 4 khng trin khai tim chng. + Ph n c thai c tim UV 2+ t 45,6% KH; gim 0,3 % so vi cng k 2019. + T l tr 18 thng tim DPT mii 4: 1.141/2.492 t 45.8% KH nm. Gim 1,5% so cng k 2019; 4.3.4. D n An ton thc phm: Tham mu xy dng, trin khai thc hin k hoch, tham gia on KTLN m bo ATTP dp Tt Nguyn n Canh T, ma L hi Xun 2020 v thng ATTP trn a bn huyn Lm H. Kt qu kim tra : - Kt qu kim tra: + Tng s on kim tra: 34 (trong  on huyn: 02; on x, th trn: 32). Kt qu  kim tra c 804/2367 (lt), trong  c 710/804 c s t chim 88,3%. + Trong 6 thng u nm khng ghi nhn v ng c thc phm trn 30 ngi mc. Tuy nhin vo ngy 30/12/2019, xy ra 01 v ng c thc phm ti Thn Thc Nghim, x M Linh vi tng s 105 ngi, sau x tr cc cas u n.  tin hnh iu tra ti thc a, ly mu bnh phm,  xut hng x l, phi hp chnh quyn a phng tuyn truyn cho nhn dn v phng nga NTP, vn ng nhn dn a phng s dng thc phm an ton c ngun gc xut x r rng. + Mt s c s khng c giy chng nhn  iu kin v sinh an ton thc phm hoc  ht hn, cha thc hin khm sc khe nh k theo quy nh, cha c giy xc nhn kin thc VSATTP, thc phm khng c ha n chng minh ngun gc xut x, ngi trc tip sn xut ch bin cha trang b y  bo h lao ng 4.3.5. D n Phng, chng HIV/AIDS : Chng trnh phng chng HIV/AIDS: trin khai thng xuyn cc hot ng theo tng d n; tng s PNMT c t vn v xt nghim HIV cho ph n mang thai: 1284 ngi; Tng s ngi nhim HIV cn sng ang qun l: 109 ngi. S ngi ang c iu tr ARV: 103 ngi. 4.3.6. D n Dn s v pht trin: - Hot ng DS-KHHG 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 : 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 (tr s sinh trai/tr s sinh gi) : 121/100 - 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 6 thng u nm t 99,58% KH, t l ph n  khm thai 3 ln tr ln trong thai k t 94,9% 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 2020 l : 10,95% gim 0,3% so vi cng k 2019, th thp ci nm 2020 l: 16,25% gim 0,05% so vi cng k 2019. - Tip tc cng c v nng cao hiu qu hot ng ca cng tc CSSKSS, tng cng qun l thai sm, thai nguy c cao, trong 6 thng khng xy ra tai bin sn khoa. - T chc chin dch t 1 cho tr t 6- 36 thng tui ung vitamin A, kt qu t 1: + Tng s tr t 6-36 thng tui c ung vitamin A: 6716/6885 t 97.5 % + B m sinh trong vng 06 thng c ung : 1045/1063 t 98.3%. 4.4. Cng tc khm cha bnh: - Duy tr tt cng tc khm cha bnh, trc chuyn mn ti cc tuyn; m bo cc i tng c khm, cp cu kp thi. - Thc hin m bo cng tc khm cha bnh an ton trong giai on dch Covid-19 theo Cng vn s 628/SYT-NVY v vic t chc phn lung, cch ly ngi nghi nhim ng h hp ti c S Y t Lm ng v cng vn s 2299/CV-BCQG ngy 24/4/2020 ca Ban Ch o Quc gia phng, chng Covid  phn lung ngi bnh ngay khi n ng k khm bnh, cp khu trang cho nhng bnh nhn nghi ng, bnh nhn c du hiu st, ho, kh th  hn ch ly lan cho ngi bnh v nhn vin y t; kp thi cch ly, khoanh vng, x l. - Tip tc trin khai ng dng cng ngh thng tin t huyn xung x trong cng tc k n v qun l thuc. - T chc sinh hot chuyn mn c duy tr thng xuyn theo k hoch. 4.6. Cng tc cng c kin ton mng li y t c s: - Kin ton li b my qun l ti tuyn y t c s, m bo s lng theo qui nh. - Trang b thm trang thit b vn phng, thit b y t, m bo cho hot ng ti trm y t. - Kt qu kim tra 16/16 x duy tr B tiu ch Quc gia v y t x giai on n nm 2020. 4.7. Cng tc ci cch hnh chnh: - TTYT  r sot li cc th tc hnh chnh n v ang trin khai,  sa i b sung mt s ni dung  thun tin cho trin khai v thun li cho ngi bnh. 4.8. Cng tc nghin cu khoa hc: - Trong nm  xt c 2  cng nghin cu khoa hc v 4 sng kin k thut, d kin s thc hin hon thnh vo qui IV 2020. 4.9. Cng tc duy tu bo dng: - Phi hp vi phng chuyn mn ca s Y t trin khai thi cng 04 cng trnh ( 3 TYT x v khu vn phng), d kin khu vn phng v 02 TYT x s a vo s dng trong 6 thng cui nm. Trin khai sa cha TYT Gia Lm v khoa Ni, khoa Nhi, ang trnh s Y t cho sa cha khu khm bnh v xy mi nh kho. - Duy tu bo dng my pht in 200KVA, 50 KVA, h thng bo chy t ng khu khm bnh, sa cha my bm cha chy, o in tr chng st khu trung tm v cc TYT x, PK KKV, h thng x l nc thi y t, , my Photocoppy, my vi tnh, h thng bc s t ng v h thng bo gi bnh nhn, ang xem xt phng n trang b mi h thng s l cht thi ly nhim thay l t rc thi y t h hng. 5. Nhng khuyt im, tn ti hn ch: - Vic thc hin cc ni qui, qui nh ti n v cha c trin khai thng xuyn, do  mt s n v hot ng cha n np. Vic b tr, sp xp li nhn lc ti mt s n v cn chm. - Thc hin cc ch tiu chuyn mn cha t theo k hoch giao. - Trin khai x hi ha chm theo k hoch. - u t cho cc TYT  t b tiu ch theo k hoch cn hn ch. T l tng dn s t nhin kh t c. 6. Nguyn nhn ca tn ti: - Cng tc ch o, t chc trin khai 1 s l)nh vc cha c th, cha ng b, kim tra, gim st, n c thc hin cha theo k hoch. - Cng tc tham mu, vai tr trch nhim ca b phn, cn b c phn cng cn hn ch, thiu su st v c th, cha nghin cu k cc vn bn  xy dng k hoch thc hin. - Nng lc, thc trch nhim ca 1 s cn b cha p ng c yu cu ngy cng cao ca cng vic, chp hnh k cng, k lut ca n v cha nghim tc. - C s vt cht khng ng b, do mt s khoa xung cp v ang c sa cha. - Mt s chnh sch mi p dng cho KCB BHYT nh khng thanh ton iu tr ni tr ti phng khm KKV, cng tc phu thut khng c BS gy m hi sc nn bnh vin khng gi li nhng bnh nng  nh hng rt ln n thu dung iu tr ti TTYT. - Tnh hnh dch bnh COVID -19 mi v ko di cing nh hng khoogn nh n hot ng KCB ti n v. NI DUNG K HOCH CNG TC NM 2021 I. Cn c  xy dng k hoch: II. D bo tnh hnh, c hi, thch thc i vi TTYT trong nm 2021: 1. D bo tnh hnh: - Dn s: 148.157 ngi, tng khong ...% so vi nm 2020. - T l tng dn s t nhin cn  mc cao khong 1,1%; - T l H ngho ton huyn cn cao; - T l ngi dn tham gia BHYT t > 90%; - Cc ch  chnh sch i vi cn b y t tuy  c ci thin nhng cn nhiu bt cp, c bit ch  thm nin, ch  ph cp u i ngh i vi ngi lao ng chuyn mn y t vi CBCCVC v ch  ph cp i vi nhn vin y t thn bn  02 TT (Nam Ban v inh Vn). 2. C hi: - Cc thay i chnh sch, ch  i vi vin chc sau cc k hp Quc hi, lut khm cha bnh sa i; - Cc gi d n HPET  trin khai y ; - Cng tc chm sc sc khe nhn dn tip tc c ng, nh nc quan tm chi o theo quan im sc kho>@   @ h l hV횄ɄpZppC-hWhU%B*CJOJQJaJmHph"""sH*hWhU%6CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmHsH*hWhU%6CJOJQJ]aJmHsH0jhWhU%CJOJQJUaJmHnHu'hWhU%5CJOJQJaJmHsHh+1CJOJQJaJmHsH$hWhU%CJOJQJaJmHsH x, $Pa$gdU% $Pa$gdU%$ SPa$gdU%$ SPa$gdU%$ Sa$gdU% $xa$gdU%$ Sa$gdU%$a$gdU%,hV&prn !! #L#$d7$8$H$`a$gdU%-DM `gdU%$dxx-DM `a$gdU% $Pa$gdU% $P`a$gdU%NVfx"pzThnѾlVCCCC$hWhU%CJOJQJaJmH*sH**hWhU%5CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmH*sH*'hWhU%5CJOJQJaJmHsH'hWhU%CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmHsH-hWhU%B*CJOJQJaJmHph"""sH-hWhU%B*CJOJQJaJmHphsHn !! #L#&$:$&%n%8&:&h&r&t&&&6'8''''''''''''(>(@(r(t((((((D)F))ؾ먙rrrrr$hWhU%CJOJQJaJmHsH'hWhU%CJOJQJ\aJmHsHhWhU%CJOJQJaJ*hWhU%5CJOJQJ\aJmHsH3hWhU%5B*CJOJQJ\aJmH*phsH*$hWhU%CJOJQJaJmH*sH*'hWhU%5CJOJQJaJmH*sH*,L##>$$&%n%t%%%%%&8& $$Ifa$gdU% $P`a$gdU% 8&:&@&% $$Ifa$gdU%kd$$Ifl4֞8W\ 4!R& F t0(44 la@&h&j&l&n&p&r& $$Ifa$gdU% $$Ifa$gdU%r&t&x&%$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 lax&&&&&&&$d$Ifa$gdU%$d$Ifa$gdU%&&&'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la&''' '.'6'$d$Ifa$gdU%$d$Ifa$gdU%6'8'@''$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la@'V'^'f't'''$d$Ifa$gdU%$d$Ifa$gdU%''''$d$Ifa$gdU%kds$$Ifl֞8W\ 4!R& F t0(44 la'''''''$d$Ifa$gdU%$d$Ifa$gdU%''''$d$Ifa$gdU%kdK$$Ifl֞8W\ 4!R& F t0(44 la'''''''$d$Ifa$gdU%$d$Ifa$gdU%''''$d$Ifa$gdU%kd#$$Ifl֞8W\ 4!R& F t0(44 la'((&(0(4(>($d$Ifa$gdU%$d$Ifa$gdU%>(@(H('$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 laH(t(z((((($d$Ifa$gdU%$d$Ifa$gdU%((('$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la((((((($d$Ifa$gdU%$d$Ifa$gdU%((('$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la(( ))()4)D)$d$Ifa$gdU%$d$Ifa$gdU%D)F)N)'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 laN)|))))))$d$Ifa$gdU%$d$Ifa$gdU%)))'$d$Ifa$gdU%kd[ $$Ifl֞8W\ 4!R& F t0(44 la))(***t*v******H+T+V+X+++,,l,n,,,,,,,-,-.-8-:-Z-v-x-------ݲݟݟݟt)hWhU%B*CJOJPJQJaJph+ j#hWhU%B*CJOJQJaJph%hWhU%B*CJOJQJaJph)hWhU%B*CJKHOJQJaJph*hWhU%5CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsHhWhU%CJOJQJaJ()))***(*$d$Ifa$gdU%$d$Ifa$gdU%(***2*'$d$Ifa$gdU%kd3 $$Ifl֞8W\ 4!R& F t0(44 la2*N*R*Z*b*l*t*$d$Ifa$gdU%$d$Ifa$gdU%t*v*~*'$d$Ifa$gdU%kd $$Ifl֞8W\ 4!R& F t0(44 la~*******$d$Ifa$gdU%$d$Ifa$gdU%***%$d$Ifa$gdU%kd $$Ifl֞8W\ 4!R& F t0(44 la*******$d$Ifa$gdU%$d$Ifa$gdU%***%$d$Ifa$gdU%kd $$Ifl֞8W\ 4!R& F t0(44 la*+"+0+<+H+V+$d$Ifa$gdU%$d$Ifa$gdU%V+X+\+'$d$Ifa$gdU%kd $$Ifl֞8W\ 4!R& F t0(44 la\+t++++++$d$Ifa$gdU%$d$Ifa$gdU%+++'$d$Ifa$gdU%kds$$Ifl֞8W\ 4!R& F t0(44 la+++++,,$d$Ifa$gdU%$d$Ifa$gdU%,,,'$d$Ifa$gdU%kdK$$Ifl֞8W\ 4!R& F t0(44 la,2,>,J,V,`,l,$d$Ifa$gdU%$d$Ifa$gdU%l,n,r,'$d$Ifa$gdU%kd#$$Ifl֞8W\ 4!R& F t0(44 lar,,,,,,,$d$Ifa$gdU%$d$Ifa$gdU%,,,%$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la,,,,,,,$d$Ifa$gdU%$d$Ifa$gdU%,,,'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la,---(-,-8-$d$Ifa$gdU%$d$Ifa$gdU%8-:->-'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la>-Z-^-b-f-r-v-$d$Ifa$gdU%$d$Ifa$gdU%v-x-|-'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la|-------$d$Ifa$gdU%$d$Ifa$gdU%---'$d$Ifa$gdU%kd_$$Ifl֞8W\ 4!R& F t0(44 la-----. .$d$1$Ifa$gdU%$d$Ifa$gdU%--- ..2.R.T.h.j......z/|/0 00000j1l1111112(2*2222223Ϻ纫n$hWhU%CJOJQJaJmHsH*hWhU%5CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsHhWhU%CJOJQJaJ)hWhU%B*CJOJPJQJaJph/ j#hWhU%B*CJOJPJQJaJph/ j$hWhU%B*CJOJPJQJaJph& ...'$d$Ifa$gdU%kd7$$Ifl֞8W\ 4!R& F t0(44 la.2.:.F.R.^.h.$d$1$Ifa$gdU%$d$Ifa$gdU%h.j.p.' $$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 lap....... $$Ifa$gdU% $$Ifa$gdU%...'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la.......$d$Ifa$gdU%$d$Ifa$gdU%...' $$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la.F/N/Z/f/r/z/ $$Ifa$gdU% $$Ifa$gdU%z/|//' $$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la//// 000 $$Ifa$gdU% $$Ifa$gdU%0 0$0' $$Ifa$gdU%kd{$$Ifl֞8W\ 4!R& F t0(44 la$0j0r0|0000 $IfgdU% $$Ifa$gdU% $$Ifa$gdU%000'$d$Ifa$gdU%kdS$$Ifl֞8W\ 4!R& F t0(44 la0000000$d$Ifa$gdU%$d$Ifa$gdU%001'$d$Ifa$gdU%kd+$$Ifl֞8W\ 4!R& F t0(44 la101<1H1T1`1j1$d$Ifa$gdU%$d$Ifa$gdU%j1l1p1'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 lap1111111$d$Ifa$gdU%$d$Ifa$gdU%111'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la111222(2$d$Ifa$gdU%$d$Ifa$gdU%(2*2.2'$d$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la.2Z2d2p2|222$d$Ifa$gdU%$d$Ifa$gdU%222' $$Ifa$gdU%kd$$Ifl֞8W\ 4!R& F t0(44 la2222222 $$Ifa$gdU% $$Ifa$gdU%222' $$Ifa$gdU%kdo$$Ifl֞8W\ 4!R& F t0(44 la233&303B3D3N3 $$Ifa$gdU% $$Ifa$gdU%303B3N3P333333 4&404<4>4l44444444450585D5F5t5555555556"626>6@6b6~666ʶʶʶʶʶʶʍʶʶw+ j$hWhU%B*CJOJQJaJph*hWhU%5CJOJQJ\aJmHsH$hWhU%CJOJQJaJmHsH'hWhU%CJOJQJ\aJmHsHhWhU%CJOJQJaJ%hWhU%B*CJOJQJaJph%hWhU%B*CJOJQJaJph.N3P3V3' $$Ifa$gdU%kdG $$Ifl֞8W\ 4!R& F t0(44 laV33333333 $$Ifa$gdU% $$Ifa$gdU%333'$d$Ifa$gdU%kd%!$$Ifl֞8W\ 4!R& F t0(44 la3 444&40424<4 $$Ifa$gdU%$d$Ifa$gdU%$d$Ifa$gdU%<4>4B4'$d$Ifa$gdU%kd"$$Ifl֞8W\ 4!R& F t0(44 laB4l4p4t4x4|44$d$Ifa$gdU%$d$Ifa$gdU%444' $$Ifa$gdU%kd"$$Ifl֞8W\ 4!R& F t0(44 la44444444 $$Ifa$gdU% $$Ifa$gdU%444%$d$Ifa$gdU%kd#$$Ifl֞8W\ 4!R& F t0(44 la45 5*50585:5D5 $$Ifa$gdU%$d$Ifa$gdU%D5F5J5'$d$Ifa$gdU%kd$$$Ifl֞8W\ 4!R& F t0(44 laJ5t5~555555 $$Ifa$gdU%$d$Ifa$gdU%$d$Ifa$gdU%555'$d$Ifa$gdU%kd%$$Ifl֞8W\ 4!R& F t0(44 la5555555$d$Ifa$gdU%$d$Ifa$gdU%555%$d$Ifa$gdU%kd]&$$Iflp֞8W\ 4!R& F t0(44 la5666"646>6 $IfgdU%$d$Ifa$gdU%$d$Ifa$gdU%>6@6D6%$d$Ifa$gdU%kd9'$$Ifly֞8W\ 4!R& F t0(44 laD6b6j6r6~666$d$Ifa$gdU%$d$Ifa$gdU%666%$d$Ifa$gdU%kd($$Ifl֞8W\ 4!R& F t0(44 la666667"7$70747l7|777777888F8b8h8r8v888888X9~9999999ȴxdxd'hWhU%CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH*sH*%hWhU%B*CJOJQJaJph%hWhU%B*CJOJQJaJph'hWhU%CJOJQJ\aJmHsH$hWhU%CJOJQJaJmHsH*hWhU%5CJOJQJ\aJmHsHhWhU%CJOJQJaJ%6666666$d$Ifa$gdU%$d$Ifa$gdU%666%$d$Ifa$gdU%kd($$Ifl֞8W\ 4!R& F t0(44 la67777$7.7 $$Ifa$gdU% $IfgdU%.70747%$d$Ifa$gdU%kd)$$Ifl֞8W\ 4!R& F t0(44 la47l7v7x7|777$d$Ifa$gdU% $$Ifa$gdU% $IfgdU%777%$d$Ifa$gdU%kd*$$Ifl֞8W\ 4!R& F t0(44 la7777778 8$d$Ifa$gdU% $$Ifa$gdU% $IfgdU% 888%$d$Ifa$gdU%kd+$$Ifl֞8W\ 4!R& F t0(44 la8F8N8Z8b8h8p8$d$Ifa$gdU% $$Ifa$gdU% $IfgdU%p8r8v8%$d$Ifa$gdU%kd,$$Ifl֞8W\ 4!R& F t0(44 lav8888888$d$Ifa$gdU% $$Ifa$gdU% $IfgdU%888%$d$Ifa$gdU%kdm-$$Ifl֞8W\ 4!R& F t0(44 la8X9f9t9~9999$d$Ifa$gdU% $$Ifa$gdU% $IfgdU%99b:% $xxa$gdU%kdU.$$Ifl֞8W\ 4!R& F t0(44 la9b:d:h:j:z::::::::::::::; ;;;;;B;H;J;L;N;X;`;j;n;p;;;;;; <<<ǴǞݞǞǞݴǞǞݴǴǴǞݞ'hWhU%5CJOJQJaJmH sH hWhU%CJaJ*hWhU%5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH sH "hWhU%5CJOJQJ\aJhWhU%CJOJQJ\aJ*b:d:j:l:::::;$$7$8$H$Ifa$gdU%;;kd=/$$Ifl4Xֈv  X R&``2 2 F8 <`'44 la^p<;;;,;B;D;F;H;$$7$8$H$Ifa$gdU% $IfgdU%H;J;kds0$$Ifl4X֞v  X R&2 FF8 (`'44 la^p(J;N;p;v;|;;;;;;;;;;;;;;;;;<<Ff6$d$7$8$H$Ifa$gdU%Ff2$$7$8$H$Ifa$gdU%$$7$8$H$Ifa$gdU%< <<<"<&<*<.<2<<<><B<`<d<h<l<p<z<|<<<<Ff?Ffw<$d$7$8$H$Ifa$gdU%$$7$8$H$Ifa$gdU%Ff=9$$7$8$H$Ifa$gdU%< <<<><z<|<<<<<<<<<<= ="=,=0=H=X=`=b=r=============>>>*>.>ڸکککککϓړ}i'hWhU%5CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH sH hWhU%CJOJQJaJ-hWhU%B*CJOJQJaJmH phsH hWhU%CJaJ$hWhU%CJOJQJaJmH sH $hWhU%CJOJQJaJmH*sH*)<<<<<<<<<<<<<<<<<<<<<<Ff_IFf%F$$7$8$H$Ifa$gdU%FfB$$7$8$H$Ifa$gdU%$d$7$8$H$Ifa$gdU%<====== ="=&=H=L=P=T=X=`=b=h====FfOFfL $$Ifa$gdU%$$7$8$H$Ifa$gdU%$d$7$8$H$Ifa$gdU%$$7$8$H$Ifa$gdU%=====================FfYFfGV$$7$8$H$Ifa$gdU%Ff S $$Ifa$gdU%$$7$8$H$Ifa$gdU%$d$7$8$H$Ifa$gdU%==> >$>&>*>,>.>2>V>Z>^>b>f>p>r>v>>>>Ff_Ff\ $$Ifa$gdU%$$7$8$H$Ifa$gdU%$d$7$8$H$Ifa$gdU%$$7$8$H$Ifa$gdU%.>f>p>r>>>>>>>>>>>>? ?b?j???iVC%hWhU%B*CJOJQJaJph$hWhU%CJOJQJaJmHsH*hWhU%5CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH'hWhU%5CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH sH hWhU%CJaJhWhU%CJOJQJaJ$hWhU%CJOJQJaJmH sH >>>>>>>>>>>>>>b?d?f?h?j? $IfgdU% $xxa$gdU%Ffif$$7$8$H$Ifa$gdU%Ff/c $$Ifa$gdU%$$7$8$H$Ifa$gdU%$d$7$8$H$Ifa$gdU%j??????@*@J@Jkdkh$$Ifl,r*''' ''j'  t'644 lap2 $$Ifa$gdU%?J@L@@@@A AAAAAPBBBCCVCXCCCCCVDXDDDHEJEEEFFFFFFrGtGGGGHZH\HHH*I,IIIIIII JJJڮڮڮڮڮڮڮڮڮڮڮڮڮڮڮڮڮڜ"hWhU%5CJOJQJ\aJ%hWhU%B*CJOJQJaJph1hWhU%56B*CJOJQJ\]aJphhWhU%CJOJQJaJ+hWhU%5B*CJOJQJ\aJph9J@L@P@h@>2) $IfgdU% $$Ifa$gdU%kdXi$$IflHֈ* !' jnx t'644 lap<h@~@@@@@2kdsj$$IflJֈ* !'&& &&j&n&x t'644 lap< $$Ifa$gdU%@@@@AAA $$Ifa$gdU% $IfgdU% $$Ifa$gdU%A Akdxk$$IflYֈ* !'&& &&j&n&x  t<'644 lap< A$ADAZAnAvAA $$Ifa$gdU% $IfgdU% $$Ifa$gdU%AAA# $$Ifa$gdU%kdl$$IflJֈ* !'&& &&j&n&x  t('644 lap<AAAAAA $$Ifa$gdU% $IfgdU%AAB# $$Ifa$gdU%kdn$$IflJֈ* !'&& &&j&n&x  t('644 lap<BPBfB|BBB $$Ifa$gdU% $IfgdU%BBkdAo$$IflYֈ* !'&& &j&n&x  t<'644 lap<BBBBBBC $$Ifa$gdU% $IfgdU% $$Ifa$gdU%CC C# $$Ifa$gdU%kdp$$IflJֈ* !'&& &j&n&x  t('644 lap< C"C&C$$IflJֈ* !'&& &&j&n&x  t('644 lap<J:J`aac:cddꯙkkRïïï0hWhU%5B*CJOJQJaJmH*phsH*-hWhU%B*CJOJQJaJmH*phsH*-hWhU%56CJOJQJ\aJmH*sH**hWhU%56CJOJQJaJmH*sH*'hWhU%5CJOJQJaJmH*sH*$hWhU%CJOJQJaJmH*sH*'hWhU%CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH*sH*:J QpQR`SRTFUxUxVV8WtW|nd $Pa$gdU% $P`a$gdU%$P-D7$8$H$M a$gdU%$P-DM a$gdU%$7P-DM `7a$gdU%$P-D7$8$H$M `a$gdU%$7P-D7$8$H$M `7a$gdU%$P7$8$H$a$gdU% tWB[N\*]N_`acdfgilnnHppqdsP^`gdU%$8xx`8a$gdU%8P^`8gdU%`gdU% P^gdU% $Pa$gdU%$xx`a$gdU%d*eeff>f@fffggii4j8jlllmm8n:nn蹠ՌxՌbKbx-hWhU%B*CJOJQJaJmH*phsH**hWhU%56CJOJQJaJmH*sH*'hWhU%5CJOJQJaJmH*sH*'hWhU%6CJOJQJaJmH*sH*1hWhU%5CJOJQJ\aJmHnHsH*u7hWhU%B*CJOJQJ\aJmHnHphsH*u$hWhU%CJOJQJaJmH*sH*.hWhU%CJOJQJ\aJmHnHsH*unnpppqqqbsdssstu,wԯycO7cc.hWhU%CJOJQJ\aJmHnHsH*u'hWhU%6CJOJQJaJmH*sH*+hWhU%CJOJQJaJmHnHsH*u6hWhU%56B*CJOJQJ\aJmH*phsH*3hWhU%5B*CJOJQJ\aJmH*phsH* hWhU%OJQJ^JmH*sH*'hWhU%CJH*OJQJaJmH*sH*$hWhU%CJOJQJaJmH*sH*0hWhU%5B*CJOJQJaJmH*phsH*dsstrxzZ}}}RRVƄ.@$xx`a$gdU% $`a$gdU% $Pa$gdU% $xxa$gdU%$8d`8a$gdU%$8xx`8a$gdU%$7d`7a$gdU%,wpxrxxz{{:{\}}}}v~PR$R<Ѽ}gG0G0g-hWhU%B*CJOJQJaJmH*phsH*>hWhU%B*CJOJQJaJfHmH*phq sH**hWhU%56CJOJQJaJmH*sH*.hWhU%5CJOJQJaJmHnHsH*u'hWhU%5CJOJQJaJmH*sH*$hWhU%CJOJQJaJmH*sH*(hWhU%@CJOJQJaJmH*sH*+hWhU%CJOJQJaJmHnHsH*u/hWhU%CJOJQJ\aJmHnHsHtH<>Lr*r(fTXjثثثu_K/7hWhU%B*CJOJQJ\aJmHnHphsH*u'hWhU%CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH*sH*0hWhU%B*CJOJQJ\aJmH*phsH*9hWhU%56B*CJOJQJ\]aJmH*phsH*-hWhU%B*CJOJQJaJmH*phsH**hWhU%56CJOJQJaJmH*sH*$hWhU%CJOJQJaJmH*sH*'hWhU%6CJOJQJaJmH*sH*@Lt*T&{{rr8`8gdU% $Pa$gdU% $`a$gdU% $`a$gdU% $`a$gdU%$xx^`a$gdU%$oxxWD:^`oa$gd!$xxWD^`a$gd.[$xxWD^`a$gd! &dXjFڙHpJPlnȧ $P`a$gdU%$7$8$H$`a$gdU%$P7$8$H$`a$gdU%$xx`a$gdU% $Pa$gdU%gdU%jlڙHpLP l<>LԪԪԪԪԗԪmWAW*hWh7HQ5CJOJQJ\aJmHsH*hWhP+5CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH$hWhU%CJOJQJaJmH*sH**hWhU%5CJOJQJ\aJmH*sH*'hWhU%5CJOJQJaJmH*sH*'hWhU%CJOJQJ\aJmH*sH*-hWhU%56CJOJQJ\aJmH*sH*ȧZ<0JL^h<V $P`a$gd#D $P`a$gd=# $P`a$gd7HQ $Pa$gd7HQ P`gdU% $Pa$gdU% $Pa$gdU%2^x±̱NZ<@BVZycO;O;'hWh!CJOJQJ\aJmHsH'hWh#DCJOJQJ\aJmHsH*hWh#D5CJOJQJ\aJmHsH*hWh7HQ5CJOJQJ\aJmHsH0hWh=#B*CJOJQJ\aJmHphsH0hWh7HQB*CJOJQJ\aJmHphsH'hWh=#CJOJQJ\aJmHsH*hWh=#5CJOJQJ\aJmHsH'hWh7HQCJOJQJ\aJmHsHV,CCFGHHJJJ6LNTNJQRTT $Pa$gdU% $P`a$gdU% $ Pa$gdU% P`gd=# $ Pa$gd#D $P`a$gd#D P`gdU% $Pa$gd#D l vn qu nht ca mi con ngi v ca ton x hi, cng vi nhng kt qu m TTYT  t c nhng nm qua l nhng c hi  thc hin tt cng tc bo v, chm sc v nng cao sc khe nhn dn huyn Lm H trong nm 2021. 3. Thch thc: - Din bin kh lng ca bin i kh hu, nhim mi trng, mt an ton v sinh thc phm; thay i c cu bnh tt, s xut hin nhng bnh dch mi... s nh hng n sc khe ca nhn dn v lm tng nguy c bng pht mt s dch bnh, i hi mng li y t phi p ng nhu cu bo v, chm sc v nng cao sc khe nhn dn; - Kinh t x hi c nc, a phng va b nh hng nng n ca i dch COVID-19, nhu cu khm cha bnh, chm sc SKB ca nhn dn ngy cng tng; - Tnh hnh nhn lc cn bt cp, thiu c v s lng v c cu (Bc s) chuyn khoa vt l tr liu); - C s vt cht cn thiu, cha ng b; - Ngn sch nh nc chi cho y t vn cn thp so vi yu cu, nhng bt cp trong quy nh thanh quyt ton khm cha bnh BHYT chm sa i, ch  i ng i vi cn b y t cn cha ph hp vi yu cu ca cng vic. III. CC MC TIU: 1. Mc tiu chung: - Tip tc cng c, pht trin mng li y t hot ng c hiu qu. Bm bo mi ngi dn c tip cn cc dch v chm sc sc khe cht lng, cng bng; - Nng cao sc khe th cht v tinh thn, tm vc, tui th, cht lng cuc sng; gim t l mc bnh v t vong do bnh tt, dch bnh, m bo ATTP, gp phn tng tui th trung bnh, nng cao cc ch s sc khe c bn ca ngi dn. 2. Mc tiu, ch tiu c th: - Gim s mc v cht do cc bnh thng gp trong chng trnh TCMR, mc un vn  la tui sinh  v bnh UVSS. m bo tuyt i an ton tim chng trong tim chng m rng, phn u t l tim chng y  8 loi vc xin cho tr em < 1 tui t > 95%, t l tim vc xin phng Un vn t > 95 % cho ph n c thai, t l tim phng v nhc li vaccin DPT t t l > 95%. - Duy tr mc sinh, nng cao cht lng dn s v th cht, khng ch tc  gia tng t s gii tnh khi sinh. Gim t vong v tnh trng suy dinh dng  b m v tr em. - Cung cp dich v khm cha bnh m bo nhu cu khm cha bnh c bn ca ngi dn. m bo cung ng  thuc, vt t y t phc v khm cha bnh v phng chng dch. - Phn u t im trung bnh cht lng bnh vin tng hn nm 2020 l 0,02 im. - m bo duy tr 100% x t B tiu ch quc gia v y t giai on n nm 2020. - Nng cao tiu ch 15 i vi 14 x t chun nng thn mi, nng thn mi nng cao, nng thn mi kiu mu (Gia Lm). - Trin khai c hiu qu dch v XHH y t, m bo ngn sch phc v cho cng tc hot ng ca n v. - Tip tc duy tr kt qu loi tr bnh Phong. Khng ch t l lu hnh bnh Phong  mc di 0,2/10.000 dn v t l ly lan bnh Phong  mc di 0,1/100.000 dn. - 50% s ngi mc bnh Phi tc nghn mn tnh c pht hin v c iu tr theo hng dn chuyn mn. - 40% s ngi bnh Hen ph qun c pht hin v iu tr  giai on sm trc khi c bin chng. - Gim t l st rt 2/1.000 dn; khng ch t l cht do St rt di 0,02/100.000 dn. - Khng  dch St xut huyt ln xy ra. Khng ch t l cht/ mc hng nm so St xut huyt < 33 ca/100.000 dn. - 100% s x/Th trn qun l tt bnh nhn Tm thn phn lit, bnh nhn ng kinh. Qun l phc hi chc nng ti cng ng cho 85% s bnh nhn ti cc x- Th trn. - 40% s ngi bnh i tho ng c pht hin sm; 30% s ngi pht hin c qun l, iu tr. - 50% s ngi b Tng huyt p c pht hin sm; 30% s ngi pht hin c qun l, iu tr theo hng dn chuyn mn. - S trng hp nhim mi HIV do ly nhim qua ng tim chch ma ty gim 15%, do ly nhim qua ng tnh dc gim 10% so vi nm 2020. - 90% s ngi nhim HIV trong cng ng bit tnh trng nhim HIV ca mnh; 90% s ngi  chn on nhim HIV c iu tr thuc khng vi rt (ARV). - Tng cng cng tc thu dung bnh nhn iu tr ni tr, ngoi tr v khm bnh t 100% KH. - T l p dng bin php trnh thai hin i 70% - Khng ch tc  gia tng t s gii tnh khi sinh, gim t sut cht tr em di 1 tui xung cn < 8,50 , t l tr em di 5 tui b suy dinh dng th nh cn < 10,75% v suy dinh dng th thp ci <16,15%. - Gim t l mc Lao mi di 20/100.000 dn - 90% c s kinh doanh dch v n ung c qun l v cp giy chng nhn c s  iu kin ATTP. - Cng sut s dng ging bnh t: e"100% - t 16-17 ging bnh, 4,4 bc s v 0,4 Dc s) trn vn dn. 3. Cc ch tiu c bn c th theo tng hot ng/ l)nh vc n nm 2021 (c bng nh km) IV Nhim v, gim php ch yu:  thc hin mc tiu v hon thnh cc ch tiu k hoch bo v, chm sc, nng cao sc khe nhn dn v cng tc dn s nm 2021, TTYT tp trung vo cc nhim v, gii php c th sau: 1. Nng cao sc khe nhn dn: - Tng cng cng tc TTGDSK  nng cao nhn thc, trch nhim, thay i hnh vi ca ngi dn v cc cp y, chnh quyn cc cp. - Xy dng v trin khai k hoch theo quyt nh 1092/ Q9-TTg ngy 2/9/2018 ca Th Tng Chnh ph bao gm cc ni dung: (1) bo m dinh dng hp l, (2) tng cng vn ng th lc, (3) chm sc sc khe tr em v hc sinh, (4) phng chng tc hi ca thuc l, (5) phng chng tc hi ca ru, bia, (6) v sinh mi trng, (7) an ton thc phm, (8) pht hin sm v qun l mt s bnh khng ly nhim, (9) chm sc, qun lv sc khe ngi dn ti cng ng, (10) chm sc sc khe ngi cao tui, (11) chm sc sc khe ngi lao ng 2. Nng cao nng lc phng chng dch bnh. Xy dng v thc hin cc chng trnh, d n v bo m ng ph kp thi cc tnh hung khn cp, c bit l cc dch bnh mi ni; trin khai ng b cc gii php  tng cng v nng cao hiu qu cng tc phng, chng dch bnh, khng  dch bnh ln xy ra. Trin khai cc hot ng phng, chng cc bnh khng ly nhim; tuyn truyn vn ng nhn dn khm sng lc, pht hin sm; y mnh vic qun l, iu tr cc bnh khng ly nhim, bnh mn tnh ti tuyn y t c s. Ch trng chm sc sc kho b m, tr em, ngi cao tui, ngi khuyt tt. Pht trin cc m hnh chm sc ngi cao tui, ngi khuyt tt, bnh mn tnh ph hp vi phong tc, tp qun, iu kin kinh t - x hi ca tng x- TT. Tp trung trin khai m hnh trm y t x hot ng theo nguyn l y hc gia nh. ng dng cng ngh thng tin trong cc hot ng ca trm y t x; trin khai qun l h s sc khe ngi dn ti cc x, th trn. 3 Nng cao cht lng khm, cha bnh: Tip tc u t nng cp khu iu tr TTYT, tng c dch v k thut c cht lng p ng nhu cu khm bnh, cha bnh cho nhn dn. Trin c hiu qu khoa Y hc c truyn- PHCN, tng cng kt hp vi y hc hin i trong phng bnh, khm, cha bnh, phc hi chc nng. Tip tc pht trin k thut thng qua cng tc o to, cc  n 1816, ch o tuyn, chuyn giao k thut... theo hng chuyn khoa  tuyn huyn v nguyn l y hc gia nh tuyn x. Duy tr hot ng ci tin cht lng bnh vin theo B tiu ch cht lng bnh vin Vit Nam; i mi phong cch, thi  phc v, giao tip ng x hng n hi lng ngi bnh; xy dng c s y t xanh, sch, p, thn thin vi mi trng. Thc hin lin thng kt qu xt nghim, chn on hnh nh, thng tin khm cha bnh gia cc c s khm, cha bnh vi tuyn y t c s  theo di, chm sc ngi bnh lin tc. ng dng cng ngh thng tin trong qun l khm, cha bnh: ng k khm, cha bnh qua in thoi, internet; qun l thng tin xt nghim, chn on hnh nh. Phi hp vi y t t nhn, chuyn giao chuyn mn k thut gia cc c s khm, cha bnh cng lp v t nhn. Tng cng cng tc Dc, TTBYT Tip tc thc hin cc gii php  bo m  thuc c cht lng, gi c hp l, p ng nhu cu phng bnh, cha bnh, phc hi chc nng cho nhn dn trn a bn, c bit cng tc u thu thuc. Cng c cng tc qun l thuc, vt t, ha cht, thit b y t, m bo qun l ng theo quy nh, tit kim v hiu qu. Pht trin nhn lc: Tng cng cng tc o to nhn lc y t, p ng nhu cu c v s lng v cht lng, chuyn mn v qun l. Tp trung o to chuyn i iu dng, n h sinh, k thut vin trnh  trung cp ln cao ng, i hc. Tng cng cng tc qun l: Thc hin c hiu qu m hnh Trung tm y t a chc nng. R sot, sp xp hp l nhn lc cc khoa, phng, TYT. Tng cng thanh tra, kim tra, gim st x l nghim vi phm. y mnh ci cch hnh chnh, ng dng cng ngh thng tin trong qun l, cung cp dch v, gim phin h, to thun li cho ngi dn. i mi ti chnh y t y mnh x hi ho y t, tng dch v y t c cht lng phc v nhn dn, tng cc ngun thu hp php. Nng cao hiu qu, cht lng hot ng cng tc dn s Nng cao hiu qu cng tc tuyn truyn, gio dc cc ch trng, ng li ca ng, chnh sch, php lut Nh nc v cng tc dn s. Ni dung truyn thng, gio dc ph hp vi chnh sch dn s v pht trin. Thc hin y  chnh sch, php lut v dn s v pht trin; c bit v cm la chn gii tnh thai nhi; vn  bnh ng gii v sc khe ngi cao tui. Nng cao hiu qu hot ng ca mng li cung cp dch v dn s ph hp vi thc t tng a phng v nhu cu ca nhm i tng. y mnh cng tc t vn, khm sc khe tin hn nhn; sc khe sinh sn trc hn nhn; cc dch v sng lc, chn on sm mt s bnh, tt trc sinh v s sinh; cung cp phng tin trnh thai v dch v chm sc sc khe sinh sn, k hoch ha gia nh. y mnh cng tc o to, bi dng, nng cao nng lc, thc hin chun ho i ngi cn b dn s cc cp; thc hin y  chnh sch i ng i vi i ngi cng tc vin dn s. Cng c c s h tng cng ngh thng tin trong qun l v dn s. V. Mt s ni dung hot ng c th: 1. Hot ng chuyn mn: 1.1. Hot ng phng, chng Lao: - Tng cng nng lc xt nghim m bo cht lng, an ton sinh hc theo quy nh. - Trin khai cc can thip tch cc, pht hin ch ng, chn on sm v qun l bnh nhn lao, lao khng thuc, bo m cht lng iu tr, tng t l iu tr thnh cng, gim t l tht bi, b iu tr, cht. - Gim st chuyn mn, hiu qu hot ng phng chng lao ti y t c s. 1.2. Hot ng phng, chng bnh Phi tc nghn mn tnh v Hen ph qun: - Tp hun li chuyn mn bnh phi tc nghn mn tnh v hen ph qun cho mng li t huyn n cc x- TT - Sng lc pht hin sm, qun l cht ch ngi bnh mc BPTNMT v HPQ, iu tr tch cc ng phc , trin khai c hiu qu phng khm chuyn khoa ti TTYT. 4.3. Hot ng phng, chng Phong - Cng c cc hot ng truyn thng, c bit truyn thng trc tip. - Tip tc duy tr khm lng ghp, khm khm pht hin v iu tr cho bnh nhn phong mi. 1.4. Hot ng phng, chng St rt. - iu tra, gim st ca bnh/  bnh st rt - Duy tr cht lng gim st dch t st rt v pht hin bnh sm, iu tr ng phc . 1.5. Hot ng phng, chng St xut huyt - Tng cng cng tc truyn thng. - Gim st dch t ti cc a bn trng im, pht hin sm tng long qung, b gy, mui truyn bnh  c ch nh x l mi trng kp thi. - Pht hin iu tr kp thi, ng phc , chuyn tuyn bnh nhn SXH theo quy nh. 1.6. Hot ng bo v sc khe tm thn - Qun l, iu tr v phc hi chc nng cho cc bnh nhn tm thn phn lit, ng kinh v trm cm  c pht hin  giai on trc. - Pht hin lp h s iu tr, qun l, phc hi chc nng cho bnh nhn tm thn phn lit, ng kinh v trm cm mi. - o to, tp hun li cng c chuyn mn cho cn b y t qun l chng trnh. 1.7. Hot ng phng, chng Ung th; - o to, tp hun li mng li chuyn mn. - Trin khai cc hot ng chm sc gim nh cho ngi bnh ung th. - Tng cng cng tc truyn thng, hng dn phng, chng bnh ung th, cc yu t nguy c cho ngi bnh v cng ng. 1.8. Hot ng phng, chng bnh tim mch - T chc khm sng lc pht hin sm, qun l ngi bnh tng huyt p. - o to, tp hun chuyn mn phng chng bnh tim mch. - T chc m hnh sinh hot cu lc b cho ngi bnh tng huyt p, tai bin mch mu no, nhi mu c tim. 1.9. Hot ng phng, chng bnh i tho ng v phng, chng cc ri lon do thiu It: - Qun l cht ch ngi mc bnh, theo ri iu tr ng phc , gim bin chng. - Pht hin sm ngi b bnh i tho ng, tin i tho ng  p dng cc bin php qun l, iu tr. - o to, tp hun li mng li chuyn mn phng, chng bnh i tho ng v phng, chng cc ri lon do thiu It. 1.10. Hot ng Y t trng hc - o to, tp hun chuyn mn phng, chng bnh, tt la tui hc ng. - Thc hin cc hot ng gio dc sc khe, thay i hnh vi v phng, chng bnh, tt la tui hc ng cho hc sinh. - Thc hin khm chuyn khoa, pht hin cc bnh, tt thng gp  la tui hc ng. - Gim st cc hot ng chuyn mn ti tuyn x. 1.11. D n: Tim chng m rng - Duy tr cng tc tim chng m rng v t chc cc chin dch tim chng, m bo tim ng lch, an ton. - Cung ng  vc xin, vt t tim chng p ng nhu cu tim chng cho tr em, ph n c thai, ph n trong  tui c thai, ph n trong  tui sinh  trong ton huyn. - Gim st chuyn mn tim chng m rng ti tuyn y t c s. - Qun l y , kp thi i tng tim chng trn h thng thng tin tim chng. 1.12. D n Dn s v pht trin: - T chc qun l d liu dn c. - T chc can thip thay i hnh vi, tp qun s dng dch v DS-KHHG v cc loi dch v ph hp vi tm l, tp qun ca ngi dn tc thiu s. - T chc can thip gim tnh trng ngi cha thnh nin, thanh nin mang thai ngoi mun, ch trng nh trng v cc a bn c th, cng c cc im cung cp dch v KHHG thn thin. - T chc 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. - Hng dn thc hnh k thut ch bin thc n v chm sc dinh dng cho ph n c thai, b m c con di 5 tui b suy dinh dng hoc tha cn bo ph; xy dng m hnh phng, chng suy dinh dng c th cho tng vng. - T chc chin dch b sung vitamin A, chin dch phng, chng suy dinh dng. 1.13. D n An ton thc phm: - T chc tp hun, o to chuyn mn an ton thc phm cho cn b lm cng tc ATTP tuyn c s. - Phi hp kim tra thc hin cc quy nh v an ton thc phm. - iu tra, gim st ng c thc phm, gim st nguy c gy nhim thc phm v phn tch nguy c ATTP, kim sot ATTP cc c s dch v n ung, bp n tp th v thc n ng ph. 1.14. D n Phng chng HIV/AIDS: - Tng cng cng tc TTGDSK, xt nghim pht hin HIV - Phn pht bm kim tim v bao cao su, u tin cc khu vc trng im HIV. M rng iu tr nghin cc cht dng thuc phin bng thuc thay th, trin khai cp pht thuc thay th theo qui nh. - Tng cng d phng ly nhim HIV t m sang con. Bo m cung ng thuc v gim st tnh hnh khng thuc ARV. 1.15. Cng tc khm cha bnh, phc hi chc nng: - Trin khai k thut mi ti n v theo ng k vi S Y t. - Trin khai iu tr ni tr cho bnh nhn YHDT. Thc hin x hi ha y t theo ph duyt ca S Y t. - Thc hin y   n 1816 ti cc tuyn theo k hoch. - Nng cao ch tiu phu thut c Ngoi khoa v Sn khoa m bo thc hin t ch tiu k hoch giao. - Duy tr tt cng tc khm cha bnh, trc chuyn mn ti cc tuyn; m bo cc i tng c khm, cp cu kp thi. - Tip tc trin khai ng dng cng ngh thng tin t huyn xung x trong cng tc k n v qun l thuc, qun l nhn s. - T chc sinh hot chuyn mn c duy tr thng xuyn theo k hoch. - Thc hin t ch tiu k hoch S Y t v UBND huyn giao hng nm. Khng  xy ra sai st chuyn mn ng tic xy ra. 1.16. Cng tc Dc, vt t, TTB y t: T chc u thu mua thuc, vt t, TTB ng theo quy nh m bo cung ng y , kp thi phc v cng tc chuyn mn; S dng hiu qu, qun l cht ch, duy tu bo dng TTB theo hng dn ca nh sn xut, m bo TTB lun  trng thi c th vn hnh c ngay khi c yu cu. - Tng cng cng tc qun l, s dng, bo co thuc, vt t, ha cht, phim XQ, khng  tht thot, lng ph. 2. V t chc mng li, vin chc : * Mng li TTYT gm: - Tip tc thc hin c hiu qu t chc b my sau kin ton theo Thng t 37/2016/TT-BYT vi 10 khoa, 05 phng chc nng; 02 phng khm a khoa khu vc; 16 TYT x  TT (c 02 phn trm y t  cc x M Linh, Ph Sn). * T chc : - Tng s lao ng 290, ( tng 03 lm hp ng 68: 01 BV, 01 tp v, 01 vn th) - Nhn vin y t thn bn 177 ngi gim 11 ngi so vi 2020 do phn chia li thn, t dn ph. - o to bi dng cn b: Tng s: 43 (chim 15,2%), trong  di hn: 43; ngn hn: 04, o to mi : 28 Ch trng o to cc chuyn khoa cn thiu ( ngoi tng qut, vt Tai mii hng, PHCN)  nng cao cht lng BV v phc v nhu cu KCB, KSK ca nhn dn trn a bn. TTHnh thc o toTng sTheo KH  ph duyto to miGhi chIo to di hn4333321BS chuyn khoa II0112BS chuyn khoa I422PHCN, GM, Ni, Nhi.3Thc s1104 BS o to chuyn mn 11SK tm thn5 BS h 4 nm7346CN iu dng337C C HA118CN YTCC09CN HS32110CN Xt nghim22211Dc s i hc84412C iu dng20201613C KTV GM014Trung cp LLCT01II o to ngn hn4421Siu m tng qut 22Qun l NN23Nghip v Dn s 4K thut b bt0015Kim sot NK BV010101 Tng (I + II)473730Trong  16 ngi DTH o to 01 lp ti TTYT huyn ( lin kt vi trng Cao ng YT Lm ng, hc vo ngy ngh trong tun khng nh hng n cng vic. - o to, pht trin ngun nhn lcv nghin cu khoa hc + y mnh cng tc o to lin tc theo qui nh ti Thng t 22/2013/TT-BYT ngy 09/8/2013 ca B Y t. Xy dng k hoch o to chuyn mn ph hp vi nhu cu s dng nhn lc  nng cao cht lng khm cha bnh v m bo c cu cn b theo qui nh. + Xy dng v thc hin k hoch tuyn dng cn b y t thc hin theo  n tinh gin bin ch,  n v tr vic lm. + T chc ng k v trin khai t nht 4  ti nghin cu khoa hc cp c s v mt s gii php hu ch, sng kin ci tin k thut 3. Ti chnh v u t y t * Mc tiu : - m bo cn i thu chi, thc hin ng cc qui nh ca ti chnh, c bit thc hin thu ng theo biu gi vin ph mi c ban hnh (Thng t 14/2019/TT-BYT ngy 05/7/2019, Thng t 39/2018 ca B Y t), qun l c hiu qu ti sn cng. - Trin khai c hiu qu  n XHH y t c ph duyt, tng ngun thu hp php, tip tc ci thin i sng vt cht cho ngi lao ng. * Xy dng c bn, nng cp sa cha v mua sm ln: - Tip tc xy dng mi nh lm kho v khu v sinh bn ngoi nh iu tr, d kin khong 3 t ng; H thng cht thi rn y t khong 3,5 t ng. - Sa cha 04 TYT x (Ph Sn, inh Vn, Lin H, an Phng)  xung cp, d kin khong 1,5 t ng. - Mua sm mt s TTB theo nhu cu thc hin danh mc k thut v theo k hoch duy tr x t B tiu ch quc gia cc nm. * Mt s hot ng khc: - Tip tc r sot, quy hoch cn b qun l, sp xp cn b vin chc ph hp vi tnh hnh n v. - y mnh ci cch hnh chnh, pht huy dn ch c s; nng cao hiu qu qun l, chng lng ph; ng dng tt cng ngh thng tin trong cng tc khm cha bnh; t chc trin khai tt cc chnh sch, php lut y t. Tng cng thanh tra, kim tra v chuyn mn ti cc n v. - Tng cng x hihocng tc y t gn vi vic thanh tra, kim tra v trch nhim ca th trng n v i vi vic thc hin hot ng x hi ho nhm gim nguy c lm dng thuc, xt nghim. - Tng cng phi hp cng - t trong l)nh vc y t nhm nng cao cht lng dch v v p ng tt hn nhu cu CSSK ca nhn dn. 4. T chc thc hin: - Giao phng KH-NV tng hp kt qu thc hin ch tiu k hoch ca tng b phn v ton n v, ch tr xy dng d tho ch tiu k hoch tham mu BG giao cho cc b phn trong n v. - Phng K ton- Ti v xy dng d ton ngn sch ton n v m bo kinh ph cho hot ng. - Phng T chc hnh chnh tham mu xy dng k hoch tinh gin bin ch, c cu cn b ton trung tm. - Cc khoa phng, i, TYT x  TT cn c vo chc nng nhim v, kt qu thc hin nm 2020 v ch tiu TTYT giao, xy dng v trin khai k hoch nm 2021. PHN TH BA KT LUN V KIN NGH I. KIN NGH: 1. Vi S Y t : - Nghin cu tip tc cp chng ch hnh ngh cho mt s chuyn khoa c bit l Gy m hi sc  p ng nhu cu khm cha bnh ti a phng. - Mua sm thm mt s trang thit b y t, ph duyt ch trng xy nh kho vc xin, ha cht, nh v sinh ca bnh nhn v lm con ng b tng cng s 2 ca TTYT (t quc l 27 i vo). - S Y t cng BHXH tnh to iu kin thun li trong vic thanh quyt ton khm cha bnh BHYT. 2. Vi Huyn u  UBND huyn: - Tip tc ch o cng tc x hi ho y t, ch o cc phng ban c lin quan, cp y v chnh quyn cc x - TT quan tm phi hp vi TTYT trong vic trin khai v thc hin cc chng trnh y t trn a bn, c bit trong cng tc duy tr x t B tiu ch Quc gia v y t x n nm 2020. - Tip tc  ngh cp c thm quyn chi kinh ph h tr hot ng i ngi NVYTTB 02 th trn (Nam Ban, inh Vn). II. KT LUN: Trn y l ni dung k hoch y t nm 2021 ca TTYT Lm H. Rt mong tip tc nhn c s quan tm ch o su st ca S Y t, huyn u  UBND huyn, s phi kt hp ca cc ban ngnh on th, chnh quyn cc a phng  TTYT Lm H hon thnh tt nhim v chnh tr c giao vi hiu qu cao nht. Ni nhn : - S Y t (Thay bo co) - UBND huyn (Thay bo co) - Phng y t ( phi hp) - BG( ch o - Lu KHNV-VT. GIM C ON MINH CNG      PAGE \* MERGEFORMAT 1 Z\BCCCCC"D4DjD&EEFF:GGGGHHTHlHHHHHmmmYYYEEE'hWhCJOJQJ\aJmHsH'hWh/CJOJQJ\aJmHsH'hWh<CJOJQJ\aJmHsH*hWh#D5CJOJQJ\aJmHsH*hWh7HQ5CJOJQJ\aJmHsH'hWhP+CJOJQJ\aJmHsH'hWh#DCJOJQJ\aJmHsH'hWh!CJOJQJ\aJmHsHU'hWhpCJOJQJ\aJmHsHHJJJJJJJJJJJJJK"KïmYE1'hWhm_CJOJQJ\aJmHsH'hWh\`CJOJQJ\aJmHsH&hWhU%5CJOJQJ\aJsH*hWhm_5CJOJQJ\aJmHsH*hWh=#5CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH'hWh#DCJOJQJ\aJmHsH'hWhKCJOJQJ\aJmHsH'hWhCJOJQJ\aJmHsH"K6K6L>LLLMMNN,N@NTNZN:Obccc$effӿua'hWhU%5CJOJQJaJmHsH hWhU%CJOJQJaJsH$hWh CJOJQJaJmHsH$hWh]3CJOJQJaJmHsH$hWhU%CJOJQJaJmHsH'hWhU%CJOJQJ\aJmHsH'hWh]3CJOJQJ\aJmHsH0hWhU%B*CJOJQJ\aJmHphsHfff ggggghhhhhiðs]G3'hWhrCJOJQJ\aJmHsH*hWh$5CJOJQJ\aJmHsH*hWhr5CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmHsH'hWheCJOJQJ\aJmHsH$hWh CJOJQJaJmHsH$hWheCJOJQJaJmHsH'hWhe5CJOJQJaJmHsH'hWhU%5CJOJQJaJmHsH'hWhm_5CJOJQJaJmHsH iij:jjjnnpnrnrrrrrs tt"t0t:tê~hVK@K5@K@K@K@hWh CJaJhWh CJaJhWh`9CJaJ"hWh`95CJ\aJmHsH*hWh$5CJOJQJ\aJmHsH0hWhrB*CJOJQJ\aJmHphsH$hWh`9CJOJQJaJmHsH0hWh`9B*CJOJQJ\aJmHphsH'hWh`9CJOJQJ\aJmHsH'hWhrCJOJQJ\aJmHsH'hWh$CJOJQJ\aJmHsHpnp~r~j 2V@ṽ0Hx~ *<Іچކz L֊؊ڊڏߺߺߺŤźhWhWCJaJhWh@CJaJhWh= CJaJhWh^bCJaJhWhCJaJhWh CJaJhWhGhCJaJmHsHhWhGhCJaJhWh CJaJhWh`9CJaJ8|>~\̃zqZqq!$$$ & F-DM a$gd !$(d-DM ]^(`a$gd!$$$ & F-DM a$gd^b!$((d-DM ](^(`a$gd & Fd-DM gd!$((d-DM ](^(`a$gdGh z|؊VmL!$d-DM ]^`a$gdW!$d-DM ]^`a$gdW!$d-DM ]^`a$gd!$$ & F-DM ]gdW!$d-DM ]^`a$gd!$$$ & F-DM a$gdV܏*^P.Jԗx2Й $P`a$gd+ $P`a$gdW $P`a$gdU% $Pa$gdU% $ Pa$gdU%$d-DM ^`a$gdWڏ܏$*,`bf 0,DL|L^ԕHJlԗڗx24̹̥̥̥̥̥p$hU%5CJOJQJ\aJmHsH!h+CJOJQJ\aJmHsH!hWCJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH$h5CJOJQJ\aJmHsH*hWhU%5CJOJQJ\aJmHsH$hW5CJOJQJ\aJmHsHhWhl@wCJaJ(̙ΙЙ*$<pDП ĠİvgUE8E8Egh+CJOJQJ\aJhWhU%CJOJQJ\aJ"hWhU%5CJOJQJ\aJh5CJOJQJ\aJ*hWhU%5CJOJQJ\aJmHsH$h5CJOJQJ\aJmHsH!h+CJOJQJ\aJmHsH'hWhU%CJOJQJ\aJmHsH'hWh+CJOJQJ\aJmHsH$h+5CJOJQJ\aJmHsH'h+h+CJOJQJ\aJmHsHЙ FП X4&fB$ 7P`a$gdU% $P`a$gdU% $P`a$gd+ĠX02\x&(dB .ޔޔyyl\OhU%5CJOJQJaJhWhU%5CJOJQJaJh5CJOJQJaJh+CJOJQJaJhWhU%CJOJQJaJh+CJOJQJ\aJh+h+CJOJQJ\aJhU%5CJOJQJ\aJh+5CJOJQJ\aJh5CJOJQJ\aJhWhU%CJOJQJ\aJ"hWhU%5CJOJQJ\aJBx.Zگ±&f.&jطdH2zJ<8 $P`a$gdU%$ 7P`a$gdU% .±&.f&.jFHPJҽֽ8<468ƿȿֶֶ֖ubbbNNNN'hWhU%CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*"hWhU%5CJOJQJ\aJh5CJOJQJ\aJhWhU%CJOJQJ\aJhWhU%5CJOJQJaJh5CJOJQJaJ%hWhU%B*CJOJQJaJphhWhU%CJOJQJaJh: CJOJQJaJh: h: CJOJQJaJ8ʿJ0z`z  6$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$P7$8$H$`a$gdo$P7$8$H$`a$gdU% $P`a$gdU%$ 7P`a$gdU%.02^txz"2xz|.`ftôppppppp]$h5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*hWhU%CJOJQJaJhWhU%CJOJQJ\aJ"hWhU%5CJOJQJ\aJh5CJOJQJ\aJhWhi CJOJQJ\aJhi CJOJQJ\aJ"hi hi 5CJOJQJ\aJhU%CJOJQJ\aJtz >FNVZ\.24ZꮘĈuuffffRR'hWhU%CJOJQJ\aJmH*sH*hWhU%CJOJQJaJ$hlhlCJOJQJaJmH*sH*hlCJOJQJaJmH*sH**h: hU%5CJOJQJ\aJmH*sH**hlhl5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*$h: hU%CJOJQJaJmH*sH**hWhU%5CJOJQJ\aJmH*sH*Zf   (046DFPTnp˹~ːo~~oo~ː['hWhU%5CJOJQJaJmH sH hWhU%CJOJQJaJ"hWhU%5CJOJQJ\aJ$hWhU%CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH sH "hohU%5CJOJQJ\aJ*hWhU%5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*hlCJOJQJaJ6Fp$ SP$7$8$H$Ifa$gdU%kdy$$IflHֈ n f!'Nr TF <%44 lap<$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% @fhjr|  "28:@B\^dfǸǸǨǸǕDžǸǸDžDžǸǨǨǨǸǕǨǸǨǸǸǨǸǸǕhWTCJOJQJaJmH sH $hWhU%CJOJQJaJmH*sH*hlCJOJQJaJmH sH hWhU%CJOJQJaJ$hWhU%CJOJQJaJmH sH 'hWhU%5CJOJQJaJmH sH !hWT5CJOJQJaJmH sH 4kd$$Iflֈ n f!'Nr TF <%44 lap<  $d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% kdÊ$$Iflֈ n f!'Nr TF <%44 lap<48<@h$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%hjkd$$Iflֈ n f!'Nr TF <%44 lap<jn~$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd$$Iflֈ n f!'Nr TF <%44 lap<$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd)$$Iflֈ n f!'Nr TF <%44 lap< $d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kdK$$Iflֈ n f!'Nr TF <%44 lap<48<>@$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%@Bkdm$$Iflֈ n f!'Nr TF <%44 lap<BFX\`bd$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%dfkd$$Iflֈ n f!'Nr TF <%44 lap<fjz~$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd$$Iflֈ n f!'Nr TF <%44 lap<$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kdӓ$$Iflֈ n f!'Nr TF <%44 lap<$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd$$Iflֈ n f!'Nr TF <%44 lap<  $d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% .DFjl$,4:<@BFZdhjrλλΥ{λλλ'hWhU%5CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH sH $hWhU%CJOJQJaJmH*sH*$hWhU%CJOJQJaJmH sH hWTCJOJQJaJmH sH hWhU%CJOJQJaJ0 kd$$Iflֈ n f!'Nr TF <%44 lap<06<BD$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%DFkd9$$Iflֈ n f!'Nr TF <%44 lap<FL`dfhj$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%jlkd[$$Iflֈ n f!'Nr TF <%44 lap<lr$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd}$$Iflֈ n f!'Nr TF <%44 lap<$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd$$Iflֈ n f!'Nr TF <%44 lap<$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kd$$Iflֈ n f!'Nr TF <%44 lap< 68:>@$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%@Bkd$$Iflֈ n f!'Nr TF <%44 lap<BFjlnpr$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% SP$7$8$H$IfgdU%rtkd$$Iflֈ n f!'Nr TF <%44 lap<rtR`l޸ގw]C3 *hWhU%56CJOJQJ\]aJmH*sH*3 *hWhU%56CJOJQJ\]aJmH sH - *hWhU%CJOJQJ\]aJmH sH 'hWhU%5CJOJQJaJmH sH *hWhU%5CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH sH hWTCJOJQJaJmH sH $hWhU%CJOJQJaJmH sH hWhU%CJOJQJaJtx$d$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% SP$7$8$H$IfgdU%kd'$$Iflֈ n f!'Nr TF <%44 lap<$$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU% SP$7$8$H$IfgdU%kdI$$Iflֈ n f!'Nr TF <%44 lap<$ SP$7$8$H$Ifa$gdU%$ SP$7$8$H$Ifa$gdU%kdk$$Iflֈ n f!'Nr TF <%44 lap<R $" $ 7Pa$gdU% $P`a$gdU%$ 7P7$8$H$a$gdU%$P7$8$H$`a$gd+1$P7$8$H$`a$gdU%$P7$8$H$`a$gdU%lx8N "jlϻ~hUBhh$h+1hU%CJOJQJaJmH*sH*$hWhU%CJOJQJaJmHsH*hWhU%5CJOJQJ\aJmH*sH**hi hi 5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*' *hWhU%CJOJQJaJmH*sH*' *hWhU%CJOJQJaJmH*sH*3 *hWhU%56CJOJQJ\]aJmH*sH*+ *hWhU%56CJOJQJ\]aJBD6HJLtxʴʝʇʇrraT@'hWhU%5CJOJQJaJmH*sH*hi 5CJOJQJaJ!hi 5CJOJQJaJmH*sH*(hWhU%0JCJOJQJaJmH*sH**hWhU%5CJOJQJ\aJmH*sH*-hWhU%56CJOJQJ\aJmH*sH**hWhU%CJOJQJ\]aJmH*sH*$hWhU%CJOJQJaJmH*sH*$h+1h+1CJOJQJaJmH*sH*h+1CJOJQJaJmH*sH*BHv$Fl<"> $P`a$gdU%$ SPa$gdU%  SPgdU% $Pa$gdU%$ 7P`a$gdU% $@":Hu_I*hWhU%CJOJQJ\]aJmH*sH**hWhU%6CJOJQJ\aJmH*sH*'h+1hU%CJOJQJ\aJmH*sH*!h+1CJOJQJ\aJmH*sH*!hi CJOJQJ\aJmH*sH**hWhU%5CJOJQJ\aJmH*sH*$hWhU%CJOJQJaJmH*sH*-hWhU%56CJOJQJ\aJmH*sH*'hWhU%CJOJQJ\aJmH*sH*Hz 02DFHJLp$ SP$Ifa$gdU%$ SP$Ifa$gdU%$ S$If`a$gdU%$ S$Ifa$gdU%$ SPa$gdU%  $02Bnprtvx|~yuyuyuyuf[fOh.[h.[mHnHuhghOJQJjhghOJQJUhJjhJUhWhU%CJaJhWhU%CJOJQJaJ*hWhU%5CJOJQJ\aJmH*sH*hWhU%CJOJQJ\aJ-hWhU%6CJOJQJ\]aJmH*sH**hWhU%CJOJQJ\]aJmH*sH*"hWhU%CJOJQJ\]aJprtvz|~|$a$$ SPa$gdU%hkd$$IflF8h&0 t&6    44 lahWhU%CJaJhJhhghOJQJ(jhghOJQJUmHnHu21h:pU%/ =!"n#n$n% $$If!vh#v#v #v#vF#v#v#v:V l4 t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V lp t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V ly t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a$$If!vh#v#v #v#vF#v#v#v:V l t0(,,55 55F555/ a4$$If^!vh#v#v2 #vF#v8#v:V l4X <`'+++++,552 5F585/ a^p<$$If^!vh#v#v2 #v#vF#v8#v:V l4X (`'+++++,,552 55F585/ a^p(6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd1$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd4$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd8$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd?;$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdy>$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdA$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l- F`'552 55F585/ a^pFkdD$$Ifl-֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd'H$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdaK$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdN$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdQ$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdU$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkdIX$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd[$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd^$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkda$$Ifl֞v  X R&2 FF8 F`'44 la^pF6$$If^!vh#v#v2 #v#vF#v8#v:V l F`'552 55F585/ a^pFkd1e$$Ifl֞v  X R&2 FF8 F`'44 la^pF$$If!vh#v#v #v#v#v :V l, t'6,55 55j5 9/ /  / ap2$$If!vh#v#v #v#v#vn#vx:V lH t'6,55 55j5n5x/ /  / / /  ap<$$If!vh#v#v #v#v#vn#vx:V lJ t'6,55 55j5n5x9/ /  / ap<Q$$If!vh#v#v #v#v#vn#vx:V lY  t<'6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<W$$If!vh#v#v #v#v#vn#vx:V lY  t<'6,55 55j5n5x99/ /  / ap<?$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x99/ /  / ap<?$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x99/ /  / ap<?$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x99/ /  / ap<?$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x99/ /  / ap<Q$$If!vh#v#v #v#v#vn#vx:V lJ  t<'6,55 55j5n5x9/ /  / ap<Q$$If!vh#v#v #v#v#vn#vx:V lJ  t<'6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<Q$$If!vh#v#v #v#v#vn#vx:V lJ  t<'6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<Q$$If!vh#v#v #v#v#vn#vx:V lJ  t<'6,55 55j5n5x9/ /  / ap<?$$If!vh#v#v #v#v#vn#vx:V l  t('6,55 55j5n5x99/ /  / ap<9$$If!vh#v#v #v#v#vn#vx:V lJ  t('6,55 55j5n5x9/ /  / ap<&$$If!vh#vN#vr #v#vT#vF#v:V lH <%,5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap< $$If!vh#vN#vr #v#vT#vF#v:V l <%5N5r 55T5F5/ ap<_$$If!vh#v#v0#v:V l t&65505^" 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH H`H U%Normal CJOJQJ_HaJmH sH tH @@@ U% Heading 1$$@&a$5\DA`D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List ZoZ U%Heading 1 Char&5CJOJQJ\_HaJmH sH tH NoN U% Header Char CJOJQJ_HaJmH sH tH 44 U%Header  !No!N U% Footer Char CJOJQJ_HaJmH sH tH 8 @28 U%Footer  !CJjoAj U%Body Text Indent 3 Char#CJOJQJ\_HaJmH sH tH RS@RR U%Body Text Indent 3$<^<a$\^oa^ U%Balloon Text Char$CJOJQJ^J_HaJmH sH tH H@rH U% Balloon TextCJOJQJ^JaJjoj U%Standard*$8$9D`,CJOJPJQJ^J_H9aJmH nHsH tHBOB U%apple-converted-space8o8 `9 Body text_ CJ_HaJtOt `9 Body Text3&$dx-D1$M a$ CJOJQJaJmHnHsHtHJoJ GhBody text (2)_5@ CJ\_HaJo Gh2Body text (2) + Verdana;4 pt;Not Bold;Spacing 0 ptR567:>*@B*CJEHOJPJQJRHd\]^J_H*aJmH*phsH*tH*o GhBody text + Spacing 2 ptR567:>*@(B*CJEHOJPJQJRHd\]^J_H*aJmH*phsH*tH*O Gh Body text (2)$d-D1$M `*5@ CJOJQJ\aJmHnHsHtHDoD ! Heading #3_5@ CJ\_HaJ~O~  Heading #3%!$d-D1$@&M a$*5@ CJOJQJ\aJmHnHsHtHPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V cy$11V(¥@#Zmu)4Pc {k<>ACMȉ<&J&M5BNe tY>?C K]_yKWzkK擭ˆGzѺU7q^۫ >hje)lꝜf d֚/_tLKԀ~\vd9|:x9|Jk (b49C=Z@ƜmWV˄ ,1&9B<ŌU\Ho0´b3 %NRA"}sYGq-xG@^sDbh(vVѼJfNqVooBQG=C? B:vݥKQJ ȉ٢m_U:AΪ". ᇄ9f' U$8fe*r0~ד <Q/ RV%@ߒw0TJi"U4o`-~ЍpVa4(F{\Uw!Cӫm:"DLD/`ƘREݩ1Mp3 r ׏+~[K&^U9}P/,].W-*D8i"H\+{lC]=5 2FhsF+Y\Ɉnì:3E[69 `&45Z!*5k8`Fmw- "d>znʜ"Z xJZp; {/<P;,)''KQk5qpNq ^,&_ &7[bn}NaB-,#f* hNV&Fgbe _躖WegFcVJD1#4b:TAJ0A?ݜrst1㘥ʭN<-BTt(w~UL_*0}X |Li{\CJ#4v@.LCPPۜ4LZ!R !{PLB]$*+S+65pU M5ʀ?9ˠQr9{mӝMfPʭæ_X]ծ7󽷬Y<+Yi+hei"skNf.xq^c,>o;:P[ l /iG8AL5m:iw֒4vќ\Hcgvlm<{2Eahdck,>ނw &xO%0YPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!j!jtheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  ***-n)-369<.>?Jdn,w<jZH"KTUfi:tڏĠtZrl\_`yyz{}~,L#8&@&r&x&&&6'@'''''''>(H(((((D)N)))(*2*t*~*****V+\+++,,l,r,,,,,8->-v-|--- ..h.p.....z//0$00001j1p111(2.22222N3V333<4B44444D5J55555>6D66666.74777 88p8v8889b:;;H;J;<<<==>j?J@h@@A AAAABBBC CVC\CCCCCVDXDDDHENEEEF FFFFFrGtGGGGHZH`HHH*I,III J:JtWds@&ȧVTpn|zVЙB86 hj@Bdf DFjl@Brtp]^abcdefghijklmnopqrstuvwxz{|}~      | $&-!8@|(  D   "?B S  ? M&} &t bookmark36 bookmark37 bookmark38 bookmark39 _Toc352774790VNS0019wxylzwxzzq 33:*urn:schemas-microsoft-com:office:smarttagsStreet;*urn:schemas-microsoft-com:office:smarttagsaddress n4hiu :<UNa5Ld-Leg!6CbyMq #;Rm2wt(Pl.Q%zS p !VVXX\\wwlj/5ǐAGғؓޙћw :Sjhiikllnoqrtu6Řhiikllnoqrtu>UZ J"sy ^0zV N567:>*@ B*CJEHOJPJQJRHd\]^J_H*aJphsH*tH*.33^3`o( ^`hH.  L ^ `LhH.   ^ `hH. ss^s`hH. CLC^C`LhH. ^`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.>UZ^0z"syt        .u        *)Y = i /^bP++1D3J7HQWT.[eol@wU%@Gh: _$`9<\`W r+]3A=#m_!#DKlpik@ !/DEKTW *,.0248<>@BDFHJfBUnknown G*Ax Times New Roman5Symbol3. *Cx ArialM Wingdings 3Symbol;VNI-Times5. .[`)Tahoma7.@ CalibrikLinux Libertine GTimes New Roman7. [ @VerdanaA$BCambria Math"1h롇'롇'.;Y>.;Y>!n42qHP ?U%2! xx ES Y T LM NG CNG HO X HI CH NGH(A VIT NAMadminAdmin   Oh+'0x $ D P \hpx\SỞ Y TẾ LÂM ĐỒNG CỘNG HOÀ Xà HỘI CHỦ NGHĨA VIỆT NAMadmin Normal.dotmAdmin2Microsoft Office Word@@ٷ.^@ٷ.^.;՜.+,0T hp  5>Y a SỞ Y TẾ LÂM ĐỒNG CỘNG HOÀ Xà HỘI CHỦ NGHĨA VIỆT NAM Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789;<=>?@ACDEFGHIPRoot Entry F`c.^RData 1Table9WordDocument4SummaryInformation(:DocumentSummaryInformation8BCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q