肺部疾病肿瘤标志物不合理检测行为的医方因素研究  

Study on the Medical Prescription Factors of Inappropriate Test of Tumor Markers In Pulmonary Diseases

作　　者：张海晨[1] 徐玉梅[1] 李剑[1] 曹士德[1] ZHANG Hai-chen;XU Yu-mei;LI Jian(Shanghai Xuhui Central Hospital,Shanghai,200031,China)

机构地区：[1]上海市徐汇区中心医院

出　　处：《中国医院管理》2019年第11期61-63,共3页Chinese Hospital Management

基　　金：上海市卫生和计划生育委员会课题（201540238）

摘　　要：目的以肺部疾病为例,调查医疗供方发生TM不合理检测行为的医方特征,为TM不合理检测现象的针对性干预提供依据。方法于2017年7-8月,邀请上海和北京各级医院临床医生参与调查,共发放240份问卷,回收有效问卷224份,有效回收率93.3%。结果 224位调查对象的肺部疾病TM既往合理检测行为比例低于50%;案例考察的不合理检测得分比例分别达到59.8%和60.3%。临床医生的医院等级(H=9.427,P<0.001)、所属科室(t=12.016,P=0.007)、科室类别(t=5.829,P=0.001)、平均月收入(r=0.179,P=0.008)与TM既往检测行为显著正相关,从医年限与案例考察得分显著正相关(r=0.141,P=0.036)。多因素回归分析结果:显示二三级医院、从医年限高、硕士研究生及以上学历的临床医生选择TM合理检测行为的概率更高(P<0.05)。结论临床医生针对肺部疾病开具TM检测的不合理情况较为普遍,其医院等级、执业类别、从医年限、收入高低、学历高低都会造成TM检测行为是否合理的差异。Objective Through taking pulmonary diseases as an example,to investigate the medical characteristics of inappropriate TM testing behavior among clinicians and provide reference for the intervention. Methods Clinicians from Shanghai and Beijing were invited to participate in the survey from July to August,2017. 240 questionnaires were issued,with an effective recovery rate of 93.3%. Results The proportion of previous appropriate testing behavior was less than50%. Scores of inappropriate testing behavior were 59.8% and 60.3%, respectively. The hospital rank(H=9.427, P<0.001),department(t=12.016,P=0.007),department category(t=5.829,P=0.001),average monthly income(r=0.179,P=0.008) had a significant positive correlation with TM detection behavior. The working lifetime had a significant positive correlation with the score of case study(r=0.141,P=0.036). Clinicians with a master’s degree and above,long working years or working at secondary or tertiary hospitals were more likely to choose appropriate TM test(P<0.05). Conclusion It is common for clinicians to prescribe inappropriate TM test. Clinicians with different practicing categories,working lifetime,hospital’s levels,monthly incomes and education background exhibit different TM testing behaviors.

关 键 词：肿瘤标志物 临床医生 不合理检测 肺部疾病 

分 类 号：R197.3[医药卫生—卫生事业管理]