北京市基层医生高血压诊疗能力及其影响因素的研究  

A cross-sectional study on factors that effect on hypertension treatment ability of physicians among district and community based hospitals in Beijing

作　　者：曾哲淳[1] 赵冬[1] 王文化[1] 贾妍娜[1] 刘颖[2] 朱秀萍 张广信[2] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所流行病研究室,北京100029 [2]北京市海淀区卫生局医管中心 [3]北京市朝阳区医药卫生协会

出　　处：《心肺血管病杂志》2008年第2期65-68,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家"十五"科技攻关课题(2001BA703B02)

摘　　要：目的:分析北京市基层医院医生高血压诊疗能力的影响因素,探索阻碍医生诊疗水平提高的原因;为卫生行政部门的医学继续教育工作提出政策建议。方法:北京市海淀区和朝阳区42家基层医院(包括二级医院9家,一级医院17家,乡卫生院16家)共计632名内科系列的医生,采用问卷调查方式,进行继续医学教育和临床能力调查。结果:1.41%的基层医生具有大学本科及以上学历,35%为大专学历,24%是中专学历,不同级别医院的医生学历构成有明显差异(P<0.01)。2.在基层医生中,高级职称占14%,中级职称占31%,有55%是初级职称,不同级别医院的医生职称构成也存在明显差异(P<0.01)。3.在总分为37分的高血压诊疗能力测试中,632名医生中最高28分,最低0分,平均(13.94±5.16)分。4.大学及以上学历、应用或阅读过高血压指南、女性、在内科或全科工作的医生测试成绩较好(P<0.05)。5.32.3%和31%的医生认为"缺乏学习时间"和"缺乏专家实际指导"是影响自身水平提高的主要原因。结论:1.北京市基层医生高血压诊疗水平存在不足。2.学历、工作科室、性别、对高血压指南的应用情况均为医生高血压诊疗能力的独立影响因素。3.影响医生水平提高的原因为"缺乏学习时间"和"缺乏专家实际指导"。Objective：To test the ability of hypertension treatment among physicians in district and community based hospital. To analyze the effective factors of this ability. Make policy suggestions on continuing medical education to the health administrative department.Method：Questionnaire survey and examination of hypertension treatment were carried out in 42 district and community level hospitals in ChaoYang district and HaiDian district, 632 physicians in internal medicine department participated.Result：1. 41% of the physicians had bachelor or even higher degree, 35% of then had junior college degree,24% of then graduated from technical school.2. 14% of those physicians had advanced technical title, 31% of then were physicians in charge, 55% were residency. The constitutional ratio of education level and technical title among different level hospitals had statistic significant （P〈0.01）. 3. The total score of the examination about hypertension treatment was 37 points,among the 632 participants the best performance was 28 points, and the worst was 0 point,the mean score was （13.94±5.16） points. 4. Physicians with higher education level, female, working in internal medicine or GP, using or ever read hypertension guide had better performance than others（P〈0.05）. The performance had no statistic difference between groups of physicians with different knowledge obtaining approach.（P〉0.05）.5. 32.3% and 31% of the physicians considered ＂lack of time for study＂ and ＂difficult to obtain directions from experts＂ as the leading obstacles that balked the improvement of their ability.Conclusion：1. The ability of hypertension treatment of physicians in district and community hospital in Beijing was insufficient. 2. Education level, working department, gender and the application state of hypertension guide were independent effective factors of the examination performance. 3. The reasons that balked the improvement of this ability were ＂lack of time for study＂, and ＂difficult to obtain direct

关 键 词：基层医院 继续医学教育 高血压防治 流行病学 

分 类 号：R181.2[医药卫生—流行病学]