湖南省放射治疗基本情况和质量安全调查

Survey on the basic situation and quality safety of radiation therapy in Hunan province

目的:调查湖南省医疗机构放射治疗资源现状和质量安全情况。方法:根据调查内容设计基本情况调查表和质量安全自评表,通过网络方式进行分发和回收,对湖南省2022年所有开展放射治疗的医疗机构(不包括部队医院)开展调查,由湖南省放射治疗质量控制中心采用分层抽样实地检查的方式核对质量安全评价情况。用Wilcoxon检验比较各单位的放疗质量安全自评得分与实地检查得分的差异。结果:截至2022年底,湖南省开展放射治疗的医疗机构共76家(不包括部队医院),其中三级医院62家、二级医院14家,年收治放疗患者总数44253人。从事放疗工作的人员共1381人,其中医师746人、物理师205人、技师397人、维修工程师33人。共有直线加速器88台(其中螺旋断层加速器3台)、伽马刀10台、后装机28台,每百万人口拥有加速器1.33台。正在开展三维适形放疗的单位有36家、静态调强放疗60家、容积弧形调强放疗20家、体部立体定向放疗27家、图像引导放疗44家、呼吸运动管理33家、后装放疗27家。质量安全评价情况中,放疗专业基本要求得分较高,2家单位取得满分,无不及格单位。放疗人员和组织、放疗流程、文档记录等方面无满分单位,得分集中在60~<80分,且均有部分单位不及格。结论:湖南省近年来放疗行业总体稳步发展,放疗人员结构趋向合理,但仍存在放疗资源分布不均,部分地区设备利用率不高、技术开展不充分的情况。质量安全方面整体较好,但在放疗人员和组织要求、流程要求和文档记录方面仍然存在许多不足,今后需要予以持续优化改进,同时将加大实地检查力度,保障放疗质量安全。

Objective To investigate the current status and quality and safety of radiation therapy resources in medical institutions in Hunan province.Methods The basic situation questionnaire,quality and safety self-assessment form were designed according to the content of the survey,distributed and recovered through the network,and the survey was conducted on all medical institutions(excluding military hospitals)conducting radiotherapy in Hunan province in 2022,and the quality and safety evaluation was checked by the Hunan Radiotherapy Quality Control Center using stratified sampling field inspection.The differences between the self-evaluation scores of radiotherapy quality and safety and the on-site inspection scores of each unit was compared using Wilcoxon test.Results By the end of 2022,there were 76 medical institutions(excluding military hospitals)conducting radiotherapy in Hunan province,including 62 tertiary hospitals and 14 secondary hospitals,with a total of 44253 radiotherapy patients admitted annually.The total number of personnel engaged in radiotherapy was 1381,including 746 physicians,205 physicists,397 technicians and 33 maintenance engineers.There were a total of 88 accelerators(including 3 tomotherapy units),10 gamma knives,and 28 rear-loading machines,with 1.33 gas pedals per million population.There were 36 units that were carrying out three-dimensional conformal technology,60 static intensity modulation technology,20 volumetric rotational intensity modulation,27 stereotactic radiotherapy,44 image-guided radiotherapy,33 respiratory motion management,and 27 rear-loading radiotherapy.In the quality and safety evaluation situation,the basic requirements of radiotherapy specialty scored high,with 2 units achieving full marks and no failing units.Radiotherapy personnel and organization,radiotherapy process,documentation record score and other aspects of no full-score units,the score was concentrated in 60~<80 points,and all have part of the unit failed.Conclusions The radiotherapy industry in Hunan province has been developed steadily in recent years in general,and the structure of radiotherapy personnel tends to be reasonable,but there still exists uneven distribution of radiotherapy resources,poor utilization of equipment in some areas,and inadequate development of technology.The overall quality and safety evaluation are good,but there are still many deficiencies in the organizational requirements of radiotherapy personnel,process requirements and documentation,which need to be continuously optimized and improved in the future,and at the same time,field inspections will be intensified to ensure the quality and safety of radiotherapy.