苏州地区健康管理(体检)机构质量控制现状分析

Analysis on the current situation of quality control of health management(physical examination)institutions in Suzhou

目的:了解苏州健康管理(体栓)机构质控现状基线资料,科学地制定对策,加强健康管理(体检)机构的规范化建设及管理。方法:本研究采用现况调查的方法。收集覆盖苏州市10个区/县(市)医疗健康体检机构的基本情况、质量控制核心指标等数据。数据录入采用EpiDa 3.1软件,统计分析采用SPSS 23.0软件,计数资料采用百分比表示,计量资料采用均数士标准差表示。服从正态分布的定量资料采用方差分析。结果:本次调查收集到的61个健康体检机构覆盖10个区/县(市),其中吴中区机构数最多,为12家,占此19.7%。其次为姑苏区,占比14.8%,昆山市健康体检机构数量最少,为1家,占比1.6%。苏州市体检机构以依托医院为主,在所有区市健康体检机构中以公立医院为主,有44家,占比72.1%,而民营医疗机构占比为27.9%。按机构级别分析,依托三.级医疗机构开展健康体检占37.7%;21.3%依托二级机构开展键康体检,其他等级的有25家,占比41.0%,其他等级主要包括一级医院和民营医院。苏州市体检机构中医生人数最多的有60队,最少的只有1人;护士人数最多的有59人,最少的只有3人。医生人数在各区市之间人数比较差异有统计学意义(Χ^2=18.735,P=0.028),护士人数在各区市之间人数比校差异没有有统计学意义(Χ^2=11.708,P=0230)。不同区/市之间质量控制(F=3.024,P=0006)和体检报告得分(F=2.266,P=0.032)差异有统计学意义。参加质控(F=2.993,P=0.006)、管理制度(F=3.775,P=0.001)、各科检查率(F=4.298,P<0.001)、放射检查室(F=2.976,P=0.006)和服务体系(F=2.695,P=0.012)五个指标得分在不同区/市之间差并有统计学意义。应急预案(F=2.544,P=0.017)和医疗废物(F=2.182.P=0.019)两个指标得分在不同区/市之间差异有统计学意义。体检报告个性化(F=3.413,P=0.002)这个指标得分在不同区/市之间差异有统计学意义。其余指标得分在不同区/市之间差异无统计学意义,P均>0.05。结论:健康管理(体检)机构在各区市之间分布不均衡,医护人员在各区市之间分布不均衡,各区市之间的质控核心指标(质量控制、安全管理和体检报告)的水平不同。健康管理机构的在质控方面发展不均衡,需要加强学习,补齐短板,努力提高质控水平。

Objective:To acquire the baseline data of quality control status of Suzhou health management(physical examination)institutions,to scientifically formulate countermeasures,and to strengthen the standardized construction and management of health management(physical examination)institutions.Methods:This study used the method of cross-sectional study to collect the basic data and core indicators of quality control of medical.The investigated health examination institutions are cover 10 districts/counties(cities)in Suzhou.EpiData 3.1 software is used for data entry,SPSS 23.0 software is used for statistical analysis.Count data is expressed in percentage,and measurement data is expressed in Mean±Standard Deviation.The quantitative data subject to normal distribution were analyzed by analysis of variance.Results:The 61 health examination institutions collected in this survey covered 10 districts/counties(cities).Among them,Wuzhong District had the largest number of institutions,accounting for 12(19.7%),followed by Gusu District,accounting for 14.8%,and Kunshan had the least number,accounting for 1.6%.Suzhou Medical institutions are mainly relying on hospitals.Among all district and city medical institutions,44 are public hospitals,accounting for 72.1%,while private medical institutions account for 27.9%.According to the analysis of institution level,37.7%of them rely on tertiary medical institutions to carry out physical examination;21.3%rely on secondary institutions to carry out physical examination.There are 25 other levels,accounting for 41.0%.Other levels mainly include first-class hospitals and private hospitals.The largest number of TCM students in Suzhou physical examination institutions is 60,and the least is only 1;The largest number of nurses was 59 and the lowest was only 3.There was significant difference in the number of doctors among districts and cities(Χ^2=1 8.735,P=0.028),and there was no significant difference in the number of nurses among districts and cities(Χ^2=1 1.708,P=0.230).There were significant differences in quality control(F=3.024,P=0.006)and physical examination report scores(F=2.266,P=0.032)among different districts/cities.The scores of five indicators of participating in quality control(P=2.993,P=0.006),management system(F=3.775,P=0.001),examination rate of each department(F=4.298,P<0.001),radiation examination room(F=2.976,P=0.006)and service system(F=2.695,P=0.012)were statistically significant among different districts/cities.The scores of emergency plan(F=2.544,P=0.017)and medical waste(F=2.182,P=0.039)were statistically significant among different districts/cities.T`he score of personalized physical examination report(F=3.413,P=0.002)was statistically significant among different districts/cities.There was no significant difference in the scores of other indexes among different districts/cities,P>0.05.Conclusion:Health Management(physical examination)institutions are unevenly distributed among districts and cities,medical staff are unevenly distributed among districts and cities,and the levels of core quality control indicators(quality control,safety management and physical examination report)are different among districts and cities.The development of health management institutions in quality control is uneven.We need to strengthen learning,make up for shortcomings and strive to improve the level of quality control.