北京市不同级别医院医生冠心病临床诊断和处理能力的评价

Evaluation on competence of diagnosis and treatment for coronary heart disease cases among physicians in community hospitals in Beijing

目的:了解北京市二级医院、一级医院和社区卫生服务中心(站)医生诊断和处理冠心病临床病例的能力。方法:2006年4月至2006年12月,采用不记名闭卷笔试的方法对北京市3个城区和6个郊区共671名医生实施"医务人员冠心病防治知识及能力"问卷调查。结果:1.51%的医生把症状和心电图疑似冠心病的诊断为冠心病;64%的医生把症状和心电图疑似稳定性心绞痛的按照冠心病进行处理。2.36%的医生能够为急性心肌梗死患者采取正确的院前急救处理措施,仅有16%的医生为冠心病患者选择的二级预防药物完全符合冠心病指南的规定。3.医生的冠心病诊疗水平总体上没有明显的城乡和学历差异。结论:医生在诊断和处理临床常见的冠心病过程中存在较多问题,应该采取相应措施提高医生的诊治水平。

Objective： To estimate the competence of diagnosis and treatment for coronary heart disease cases among physicians in district and community hospitals in Beijing. Method： The questionnaire survey was investigated with a close book examination among 671 physicians in 9 districts of Beijing from April 2006 to December 2006. Result：1. The percentage of physicians who diagnose the suspect CHD case as CHD patient is 51%, and the percentage of physicians who treat suspect stable angina case as CHD patient is 64%. 2. 36% of physicians adopt correct emergency approaches for acute myocardial infarction patients, only 16% of physicians select correct secondary prevention therapies for CHD patients. 3. The competence of diagnosis and treatment for coronary heart disease cases has no obvious difference among physicians with various characteristics. Conclusion： The competence of diagnosis and treatment for coronary heart disease cases among physicians in community hospitals is low and should be improved urgently.