影像学重复医疗检查现状及对策分析

Unnecessary repetition in medical imaging examination and its countermeasures

目的了解影像学重复医疗检查现状,为政府采取相应干预措施、降低患者医疗费用提供参考。方法于2017年1—3月通过现场调查和远程问卷方法展开调查,利用Excel和SPSS 19.0对数据进行统计分析。结果共回收有效问卷426份,其中220例患者做过影像学医疗检查,影像学重复医疗检查发生率为41.82%,综合医改试点地区影像学重复医疗检查发生率为21.43%,低于其他地区44.79%的发生率;不同地区经济水平、医院级别及检查类别影像学重复医疗检查率间差异无统计学意义(P>0.05);仅有15.22%的影像学重复医疗检查影响对患者疾病的最终诊断。结论影像学重复医疗检查发生普遍,需加快综合医改试点地区经验分享与推广工作,完善医疗检查结果互认制度体系;独立设置区域医学影像诊断中心,促进医疗资源共享。

Objective To examine current situation of unnecessarily repeated medical imaging examination and to provide references for governmental agencies to implement relevant intervention. Methods We conducted intemet-based questionnaire surveys and field interviews among 450 medical examinees recruited in 26 provinces across China from January to March, 2016. We analyzed the data using SPSS 19.0. Results Among all the 426 participants with eligible response, the occurrence rate of repeated imaging examination was 41.82% and the rate was 21.43% among the participants in regions covered by pilot implementation of medical reform, which was obviously lower than that （44.79%） among the participants in other regions. There were no significant differences in the occurrence rate of repeated imaging examination among the participants in regions with disparate economic development, at hospitals of different level, and taking various kinds of imaging （ P 〉 0.05 for all ）. Of all the repeated examinations reported, only 15.22% resulted in alterative final diagnosis of the participants＇ diseases. Conclusion Repeated imaging examination is prevalent among medical examinees in China. Promotion of mutual recognition of medical examination outcomes and establishment of regional medical examination centers may play roles in sharing medical resources to control unnecessary repeated imaging examination.