中国临床医生罕见病认知度及影响因素分析:基于唐山调研数据

Cognition on rare diseases and associated factors in Chinese clinicians:a cross-sectional survey in Tangshan city

目的评估中国临床医生对罕见病的认知程度,为进一步提高罕见病认知度和诊疗水平提供参考。方法利用2018年唐山地区医生罕见病诊治现状调查数据,采用描述性统计方法和logistic回归模型,探讨认知度在医生个人特征、所在医院特征、日诊疗量和知识获取渠道等方面的差异,分析临床医生罕见病认知度及其影响因素。结果本科和硕士及以上临床医生对于罕见病的认知得分相对于专科医师高出0.59分(P<0.01)和0.79分(P<0.01),在三级医院工作的医生对于罕见病的认知得分比二级医院高出0.64分(P<0.01);与治疗1~2位患者的医生比较,治疗3~5位患者/h和治疗>5位患者/h的医生认知得分分别高出0.24分(P<0.05)和1.10分(P<0.05)。结论提升临床医生教育水平和临床治疗经验,有助于罕见病的及时发现、减少误诊率及减少患者因误诊导致的额外负担。

Objective To evaluate the cognition on rare diseases and its associates in Chinese clinicians and to provide references for improving the diagnosis and treatment of rare diseases.Methods A self-administered questionnaire survey was conducted among 2065 clinicians in 14 public general hospitals of various levels in Tangshan municipality in 2018.Descriptive statistics and logistic regression analysis were performed to analyze the clinicians’cognition on rare diseases and its influencing factors.Results Valid responses were collected from 1853 clinicians.Compared to the those with collage degree,the respondents with bachelor degree and master degree and above had a significantly higher average cognition score(3.97 and 4.43 vs.3.36,both P<0.01)for the scale with a mean score of 4.01;the average cognition score of the respondents working in tertiary hospitals was significantly higher than that of the respondents in secondary hospitals(4.54 vs.3.82,P<0.01);in comparison with those providing medical service to 1–2 patients in an hour averagely,the respondents providing the service to 3–5 and 6 or more patients had significantly higher average cognition score(4.21 and 5.03 vs.3.94,both P<0.05).Conclusion Improving professional education of the clinicians and promoting technical training among clinicians in secondary hospitals could contribute to timely diagnosis and reduction in misdiagnosis of rare diseases in China.