上海市医疗技术准入配置特征追踪研究

Configuration feature of medical technology admittance in Shanghai: A tracking study

目的:探索上海市医疗技术准入的配置特征,为政府卫生行政部门科学管理提供决策依据。方法:描述性分析准入技术的基本情况、空间分布、机构分布、类别及应用病种等。结果:共准入第二类及本市首次开展技术917项,技术种类为101种,涉及医院166家。准入技术主要为本市首次开展的医疗技术,占82.2%。准入技术的空间分布不均衡,中心区域技术配置数量明显高于郊区;三级医院申请的医疗次数和种类均较二级、一级医院多,但三级医院平均申请次数低于二级医院。主要准入技术种类为手术治疗、实验室诊断和物理治疗,共占准入总数的90.1%。主要技术方法为微创、快速定量诊断及超声等先进技术方案,诊疗病种主要为心血管疾病和肿瘤等慢性疾病。准入的前三位技术分别为妇科内镜诊疗技术、白内障超声乳化和髋膝关节置换技术。结论:上海市医疗技术准入主要为本市首次开展的医疗技术,技术配置空间分布不合理,建议加强准入技术在郊区及基层医院的推广应用,并进一步加强准入技术的监管和跟踪评估。

Objective： To explore the configuration feature of medical technology admittance in Shanghai City in y, were admitted. These fell into 101 kinds of technology and involved 166 hospitals. Admittance technologies were mainly the firstly used in Shanghai and accounted for 82. 2% of total. Spatial distribution was uneven, central region was obviously better than the suburbs. The technology types and frequency declared in tertiary hospitals were higher than in secondary and primary hospitals, but the average applied number for the same technology was higher in sec- ondary hospitals. The main technology included operation treatment, laboratory diagnosis and physical therapy, which accounted for 90. 1 percent of the total number of the declaration. The main methods were minimally invasive surger- y, rapid or quantitative diagnosis, and ultrasound and other technologically advanced procedures. Target diseases mainly included cardiovascular disease, cancer, and other chronic diseases. The top three technologies were gyneco- logic endoscopic treatment technology, cataract technology, and hip and knee replacement technology. Conclusion： Medical technology admittance was mainly firstly carried out and spatial configuration was not reasonable in Shanghai. We suggest improving the popularization and application of access technology in the suburbs and primary hospitals, strengthening regulating regulation and tracking assessment.