北京地区2010-2016年唐氏综合征产前血清学筛查机构运营情况分析

Operation of prenatal serological screening institutions for Down’s syndrome in Beijing from 2010 to 2016

目的了解北京市唐氏综合征产前血清学筛查机构的运营情况,为优化产前筛查管理工作提供决策证据。方法基于北京市第2次、第3次全国产前筛查和产前诊断服务专项调查及年度报表数据,从机构、人员、技术、服务提供等方面分析血清学筛查机构运营现状及变化情况。结果2013至2015年北京市血清学筛查机构及采血点有72家,84.62%的机构管理方式为备案制,具备资质的筛查技术人员199名。筛查方案以中孕期三联筛查为主,实验室检测方法主要为化学发光法。2010-2016年年均分娩量为21.56万例,血清学筛查年均服务量为18.73万例,筛查量增长了约89.93%,血清学筛查覆盖率平均为86.89%;7年间血清学筛查的每机构服务量增加了95.4%,每人员服务量增加了35.2%。妇产专科医院和妇幼保健院的每机构服务量与每人员服务量均高于其他类别(P<0.01)。综合医院、三级医疗机构是服务提供的主力,但存在由城市地区向远县地区转移,三级机构向二级机构转移的趋势。结论北京市唐氏综合征产前血清学筛查机构的运营和管理较为规范,筛查覆盖率较高,服务量及服务效率增幅明显。

Objective:To learn the capability and functioning status of prenatal serological screening institutions for Down’s syndrome in Beijing and inform decision-making on the optimization of prenatal screening management.Methods:By using the data from the second and the third National Special Survey on Prenatal Screening and Prenatal Diagnostic Services in Beijing and annual statement data,we analyzed the distribution,human resources,technology,and workload of prenatal serological screening institutions for Down’s syndrome in Beijing as well as their changing trends.Results:From 2013 to 2015,there were 72 prenatal serological screening institutions(including blood collection institutions)for Down’s syndrome,84.62%of which were registered hospitals for prenatal serological screening.There were 199 qualified prenatal serological screening technicians.Triple screening during mid-pregnancy is the main screening scheme,and chemiluminescence method is the main laboratory testing method.From 2010-2016,the average delivery volume per year was 215600 cases and the average prenatal serological screening volume per year was 187300 cases which increased 89.93%.The coverage rate of prenatal serological screening was about86.89%.during 7 years.In the same period,the number of serological screening services per institution increased from 1761 to 3441 with an increase rate of 95.4%,and the service volume per person increased from 616 to 833 with an increase rate of 35.2%.The prenatal screening services volume per institution and per person in the maternity hospitals and maternal&child health hospitals were higher than those of other categories(P<0.01).The general hospitals and tertiary hospitals were the main sources of the services,but the prenatal screening services transferred from tertiary institutions to secondary institutions and from urban areas to suburban areas during 7 years.Conclusion:The operation and management of prenatal serological screening institutions for Down’s syndrome in Beijing are relatively standard.The coverage rate of prenatal serological screening is relatively high in Beijing and the screening service volume and effect increased sharply.