上海市社区医学检验服务能力状况调查分析

Survey and analysis of Shanghai community medical laboratory service capacity

目的:分析现阶段社区医学检验科建设中存在的问题。方法:于2021年12月—2022年12月期间收集上海市所有社区卫生服务中心检验科的相关信息。课题组在咨询相关专家、查阅社区医学检验相关政策文件及文献的基础上制订调查问卷,问卷由检验科负责人进行填写。结果:190家社区卫生服务中心中,173家检验科的使用面积在30~160 m2之间;本科及以上学历的检验科负责人、检验人员占比分别为77.4%、72.4%,中级及以上职称的检验科负责人、检验人员占比分别为87.9%、51.9%。190家社区卫生服务中心均未配备一般细菌鉴定仪及分子检测分析仪,酶标仪、尿HCG半定量检测仪、二氧化碳培养箱、血脂检测仪等配备较少,配备率≥50.0%的检验设备有12种。187家社区卫生服务中心与医疗联合体或第三方检验机构签订了检验外送协议,2017—2021年外送检测业务量呈逐年上升趋势。87家社区卫生服务中心在2017—2021年间开展了相关课题研究,共发表论文266篇。各社区卫生服务中心的检验质量均维持在较好水平,2021年临床生化项目、临床免疫项目、体液血液项目的室间质量评价合格率分别为99.4%、96.5%、100.0%。结论:社区卫生服务中心应对照相关政策标准,持续改进服务质量,不断完善基础设施条件,加大对检验实验室的投入与人才引进力度,促进基层实验室检验与管理能力的提升。

Objective:To analyze the problems in the construction of the community medical laboratory at the present stage.Methods:Information about the laboratory departments of all community health service centers in Shanghai was collected during the period of December 2021 to December 2022.The project group developed a questionnaire based on consultation with relevant experts and review of policy documents and literature related to community medical testing,and the questionnaire was filled out by the head of the laboratory departments.Results:Among 190 community health service centers,173 laboratory departments had useable areas between 30 and 160 m2;the percentages of laboratory department heads and laboratory personnel with bachelor’s degrees and above were 77.4%and 72.4%,respectively,and the percentages of laboratory department heads and laboratory personnel with intermediate titles and above were 87.9%and 51.9%,respectively.One hundred and ninety community health service centers were not equipped with general bacterial identification instrument and molecular detection analyzer,enzyme marker,urine HCG semi-quantitative detector,carbon dioxide incubator,and lipid detector,etc.were less equipped with 12 kinds of testing equipment with a rate of≥50.0%.One hundred and eighty-seven community health service centers signed agreements with medical consortia or third-party testing institutions to send out tests,and from 2017 to 2021 the sending out the number of testing operations increased year by year.Eighty-seven community health service centers carried out project research on relevant topics during 2017 to 2021,and published 266 papers.The test quality of each community health service center was maintained at a good level,and the inter-room quality evaluation pass rates of clinical biochemical items,clinical immunology items,and body fluid and blood items were 99.4%,96.5%,and 100.0%in 2021,respectively.Conclusion:The community health service centers should continuously improve the service quality against the relevant policy standards,continuously improve the infrastructure conditions,and increase the investment in testing laboratories and the introduction of talents to promote the improvement of the testing and management capacity of primary laboratories.