【摘要】 目的了解四川省超声医学专业质量控制管理现状,为探索更加高效的质量控制管理策略建立基础。方法对四川省708家医院2018年1月1日至12月31日超声质量控制的基本数据(人员构成、设备情况、工作量和质量控制综合评分)进行采集。采用χ~2检验比较不同等级医院间超声人员的学历、职称、年龄分布、人员资质情况的差异,采用秩和检验比较不同等级医院间工作量各个指标(机构医患比,门诊、住院、急诊日均检查人次,平均日均检查人次和超声报告阳性率)的差异,采用方差分析比较各市州间以及不同等级医院间质量控制管理综合评分的差异。结果四川省共纳入三级甲等医院69家,三级乙等医院102家,二级甲等医院195家,二级乙等医院105家,一级及其他医院319家。(1)不同等级医疗机构间超声医师人员情况比较:学历构成比(χ~2=1631.46,P<0.001)、职称构成比(χ~2=797.622,P<0.001)、年龄分布(χ~2=113.161,P<0.001)、医师证书持有率(χ~2=11.813,P=0.027)比较,差异均具有统计学意义。(2)不同等级医院超声设备占比:随医院等级降低,进口设备占比逐渐降低,10年及以下设备和国产设备占比呈逐渐增高趋势。(3)不同等级医疗机构医患比[三级甲等医院:1.38(1.04,2.06)、三级乙等医院:1.49(1.15,1.90)、二级甲等医院:2.00(1.49,2.80)、二级乙等医院:2.88(1.90,5.39)、一级及其他医院:3.99(2.33,8.42)]比较,差异无统计学意义(H=1.775,P=0.132),但显示随医院等级降低,医患比有上升趋势。(4)不同等级医疗机构间门诊、住院、急诊日均检查人次,平均日检查人次差异均有统计学意义(H=50.429、45.232、34.956、73.633,P均<0.001):显示随医院等级降低,均呈下降趋势。(5)不同市州医院的质量控制管理综合评分差异有统计学意义(F=5.187,P<0.001);不同等级的医院质量控制管理综合评分差异有统计学意义(F=98.189,P<0.001)。结论由于四川省不同等级医疗机构超声医学专业质量控制管理存在差异,根据医院等级建立考评制度更有利于质量控制工作的高效开展。更多还原

【Abstract】 Objective To investigate the current situation of quality control management of ultrasonic medicine in Sichuan Province, China, and to establish a basis for exploring more efficient management strategies. Methods The basic data of ultrasonic quality control(qualification of ultrasound doctors, proportion of ultrasound equipment, operation capacity, and total score of quality control management) of 708 medical institutions in Sichuan Province, China were collected from January 1 to December 31, 2018. The χ~2 test was used to compare the differences of academic qualifications, professional title, age distribution, and qualification of ultrasound personnel among different levels of hospitals. The rank sum test was used to compare the differences of various indexes of inter-hospital workload(staff-patient ratio, daily average numbers of outpatients, inpatients, and emergency examinations, and daily average number and positive rate of ultrasonic reports). ANOVA was used to compare the differences of quality control management comprehensive scores among cities and different levels of hospitals. Results The survey included 65 third-grade class-A hospitals, 95 third-grade class-B hospitals, 182 second-grade class-A hospitals, 94 second-grade class-B hospitals, and 271 medical institutions of other levels. The differences in the ratio of educational background(χ~2=1631.46, P<0.001), the composition of professional titles(χ~2=797.622, P<0.001), age composition(χ~2=113.161, P<0.001), and the holding rate of doctors’ certificate(χ~2=11.813, P=0.027) were statistically significant among different levels of hospitals. With the decrease of hospital grade, the proportion of imported equipment decreased gradually, and the proportion of domestic equipment and equipment under 10 years increased gradually. The difference in staff/patient ratio was not statistically significant(third-grade class-A 1.38(1.04, 2.06), third-grade class-B 1.49(1.15, 1.90), secondgrade class-A 2.00(1.49, 2.80), second-grade class-B 2.88(1.90, 5.39), and others 3.99(2.331, 8.42),H=1.775, P=0.132), though there was an upward trend with the decrease of hospital grade. There were statistically significant differences in the daily average numbers of outpatients, inpatients, and emergency examinations, as well as daily average number of examinations among different hospital grades(H=50.429,45.232, 34.956, and 73.633, respectively, P<0.001); the results showed that with the decrease of hospital grade, the trend was downward. The total score of quality control management among different cities and states of medical treatment were statistically significant(F=5.187, P<0.001). The total score of quality control management among different grades of medical institutions was also statistically significant(F=98.189, P<0.001). Conclusion Because there are differences in quality control management of ultrasonic medicine specialty among different levels of medical institutions in Sichuan Province, the evaluation system based on the hospital level is conducive to carrying out efficient quality control management.更多还原