辽宁省恶性肿瘤诊治规范执行情况抽样调查

Sampling survey of implementation of guidelines for diagnosis and treatment of malignant tumors in Liaoning Province

目的对辽宁省各级医疗机构恶性肿瘤诊治规范执行情况进行抽样调查,统计分析恶性肿瘤的诊治规范执行情况,为卫生行政及相关部门制定肿瘤防治计划、规划及质控办法提供参考依据,最终实现提高全省恶性肿瘤治疗水平和诊治规范率的目的。方法采用整群二阶段随机抽样,在收治肿瘤的292所医院中,遴选37所不同类型、不同级别医疗机构内科、外科和放疗科常见恶性肿瘤的出院病志,填写调查表,对各级别医疗机构进行数据统计及卡方检验。结果共收集有效调查表4514份,诊治规范率为41.2%,其中手术、化疗和放疗诊治规范率分别为33.4%、51.1%和37.3%。A类和B类医院高于C类医院;城市医院高于农村医院;在各级别医疗机构中,以有肿瘤科的市直综合医院诊治规范率最高,为55.6%;常见癌种中,乳腺癌的诊治规范率最高,为53.5%。结论建立恶性肿瘤诊治规范推广及相应的质量控制和考核方法的管理机制,提高全省恶性肿瘤诊治水平势在必行。

Objective A sample survey on the implementation at all levels of medical institutions in Liaoning province in malignant tumor diagnosis and treatment standards, Implementation guidelines for diagnosis and treatment of the statistical anal- ysis of malignant tumor, to provide reference basis for health administrative and related departments to develop cancer preven- tion plan, planning and quality control measures, finally realize the province level and the diagnosis and treatment of malignant tumor treatment standard rate goal. Methods Using a cluster of two stage random sampling, in 292 the hospital treated tumor. a common malignant tumor in the selection of 37 different types, different levels of medical institutions in Department of internal medicine, surgery and radiotherapy department discharge records, fill in the questionnaire, statistical data on all levels of medical institutions and the chi square test. Results A total of 4514 effective questionnaires were collected, diagnosis and treatment of standard rate was 41.2% ,the operation ,chemotherapy and radiotherapy Diagnosis and treatment of standard rate were 33.4% ,51.1% and 37. 3%. A class and B class hospitals above class C hospital; city hospital was higher than rural hos- pital ; In all levels of medical institutions, Under the comprehensive hospital diagnosis standard to have the highest rate of On- tology,55.6%; The common cancers, guidelines for diagnosis and treatment of breast cancer was the highest, 53.5% . Conclusion Management mechanism for the establishment of criteria for diagnosis and treatment of malignant tumor promo- tion and the corresponding quality control and evaluation method, be imperative to improve the province＇s malignant tumor treat- ment.