“十三五”期间我国县级医院大型医用设备配置与管理策略研究

Study on the Allocation and Management Strategy of Expensive Medical Equipment in County-level Hospitals During the 13th Five-year Plan Period in China

目的:分析“十三五”时期县级医院大型医用设备配置和管理情况,为县级医院管理和卫生健康管理部门制定相关政策提供依据。方法:选取东、中、西地区各2个省份的县级医院作为研究对象,通过向样本省份卫生健康行政部门发放调查表的形式收集大型医疗设备配置水平和结构数据以及使用情况等资料。结果:样本县级医院共配置乙类大型医用设备为3317台,这6类设备数量构成比分别1.72%、0.03%、37.65%、47.75%、12.21%和0.63%。东部、中部和西部地区县级医院大型医疗设备配置数量逐步减少。配置数量最多设备主要为1.5T及以上核磁共振成像系统(MIR)和64排及以上X线计算机断层扫描仪(CT),且中部和西部地区省份大型医疗设备使用率低于东部。结论:我国县级医院大型医用设备存在实际配置标准和使用监管机制不完善、配置结构不合理等关键问题,建议科学布局大型医用设备、加大设备配置和使用监管力度、完善配置标准和许可退出奖惩机制。

Objective:To analyze the configuration and management of expensive medical equipment in county hospitals during the 13th five-year plan period,so as to provide references for county hospital management and making relevant policies by health department.Methods:The county-level hospitals in two provinces in the east,central and western regions were selected as the study objects.Data such as configuration level,structure data and usage of large-sized medical equipment were collected by issuing questionnaires to health administrative departments of sample provinces.Results:The sample county-level hospitals were equipped with 3317 the second-class expensive medical equipment,and the proportion of the six types of equipment was 1.72%,0.03%,37.65%,47.75%,12.21% and 0.63%,respectively.The number of large-sized medical equipment in county-level hospitals in eastern,central and western regions was gradually decreasing.The largest number of equipment in hospitals was magnetic resonance imaging systems(MRI)with 1.5T and above and X-ray computed tomography(CT)scanners with 64 rows and above,and the utilization rate of large medical equipment in central and western provinces was lower than that in eastern provinces.Conclusion:There are some key problems in the implementation of expensive medical equipment configuration in county hospitals in China,such as the imperfect supervision mechanism of configuration and use and actual configuration standard,and the unreasonable configuration structure.It is suggested that we should scientifically arrange expensive medical equipment,strengthen supervision over equipment configuration and use,improve the configuration standard and optimize the reward and punishment mechanism of withdrawal in line with license.