我国职业病诊断机构及诊断医师资质分析

Analysis of qualifications of medical and health institutions and certified doctors for providing occupational disease diagnosis in China

目的 了解我国职业病诊断机构和诊断医师的资质和工作现状,为制定相关政策提供参考.方法 主要采用工作报告和问卷调查的形式,调查我国所有职业病诊断机构和诊断医师的资质获得情况和2006年至2010年职业病诊断受理情况等,其中工作报告回复率100.0％,问卷调查回收率71.0％.结果 截止2010年底,全国除港澳台地区外的31个省、自治区和直辖市共有503家医疗卫生机构获得职业病诊断机构资质,其中疾病预防控制中心207家（41.2％）,综合医院145家（28.8％）、企业医院69家（13.7％）、职业病防治院所及中心64家（12.7％）；4986名医师获得职业病诊断医师资格,平均每家诊断机构9.4名,每10万从业人口拥有职业病诊断医师0.65名；16.5％的机构取得了全部9大类职业病诊断资质,17.1％的机构只取得了其中某一类职业病诊断资质；每名职业病诊断医师每年受理职业病诊断病例16.8例.结论 我国已基本建立全国性的职业病诊断网络,但诊断机构和诊断医师在地区分布和专业项目上存在不平衡性,需要进一步加强区域机构建设和诊断医师培训.

Objective To investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies.Methods Work reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010.The rate for the work reports was 100％,and the response rate for the questionnaires was 71.0％.Results By the end of 2010,in the 31 provincial-level regions （excluding Hong Kong,Macao,and Taiwan） in China,there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis,including 207 centers for disease control and prevention,accounting for 41.2％,145 general hospitals,accounting for 28.8％,69 enterprise-owned hospitals,accounting for 13.7％,and 64 institutes or centers for occupational disease prevention and control,accounting for 12.7％; 4986 certified doctors got the qualification for providing occupational disease diagnosis,with 9.4 certified doctors on average in each institution,and there was 0.65 certified doctor per 100 000 employees.In addition,16.5％ of the institutions got all the qualifications for diagnosing 9 occupational diseases,and 17.1％ of the institutions got the qualification for diagnosing one occupational disease.Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year.Conclusion A national occupational disease diagnosis network has been established in China,but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors.It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified doctors.