辽宁省医疗机构七类常用影像设备利用水平及其相关因素分析  

Analysis on the Utilization and Related Factors of Seven Types of Common Imaging Devices in Medical Institutions in Liaoning Province

作　　者：马祥[1] 张蕊[1] 李爽[1] 刘运泳[2] 胡希 潘国伟 刘莉[1] MA Xiang;ZHANG Rui;LI Shuang;LIU Yunyong;HU Xi;PAN Guowei;LIU Li(Institute of Chronic Non-Communicable Diseases Control and Prevention,Liaoning Provincial Center for Disease Control and Prevention,Shenyang Liaoning 110005,China;Liaoning Provincial Cancer Prevention and Control Office,Liaoning Cancer Hospital&Institute,Shenyang Liaoning 110042,China;Department of Science and Education,Liaoning Research Institute of Family Planning,Shenyang Liaoning 110031,China;Research Center for Universal Health,School of Public Health,China Medical University,Shenyang Liaoning 110122,China)

机构地区：[1]辽宁省疾病预防控制中心慢性非传染性疾病预防控制所,辽宁沈阳110005 [2]辽宁省肿瘤医院辽宁省肿瘤防治办公室,辽宁沈阳110042 [3]辽宁省计划生育科学研究院科教科,辽宁沈阳110031 [4]中国医科大学公共卫生学院全民健康研究室,辽宁沈阳110122

出　　处：《中国医疗设备》2020年第12期129-132,141,共5页China Medical Devices

基　　金：国家重点研发计划(2017YFC0114201);辽宁省各级医疗机构创新诊疗装备配置意愿调查研究(20180550305)。

摘　　要：目的通过对辽宁省9个示范区/县医疗机构7种常用影像设备利用水平的描述和相关因素的分析,为当地医疗设备的科学配置和管理提供客观依据。方法利用自制调查表收集各级医院7种常用设备的数量、品牌、年检查人次数、医疗机构诊疗量、收入支出等信息并进行比较和相关性分析。结果共调查相关设备417台,最终348台纳入分析(83.5%)。不同级别医疗机构的设备年检查人次数差距较大,呈现三级、二级、一级依次递减的趋势。91.7%的CT机在三级医疗机构存在利用严重过度的现象;二级医疗机构的CT利用不足和利用过度现象并存(5.6%利用不足,27.8%利用过度),33.3%的磁共振成像(Magnetic Resonance Imaging,MRI)设备在二级医疗机构有利用过度的情况。数据X线摄影(Digital Radiography,DR)、超声等设备年检查人次数与医疗机构服务人口数、实际开放床位数、年门急诊量、年首诊人次数、年医疗业务总收入、年设备诊疗收入、年设备维修费支出呈显著正相关。DR、超声设备进口品牌的年检查人次数显著高于国产品牌(P<0.001)。不同购置年代的设备年检查人次数未发现具有统计学差异。结论不同级别医疗机构的影像设备年检查人次数呈现三级、二级、一级依次递减的趋势。大型影像设备在三级医疗机构以利用过度为主,在二级医疗机构利用过度与不足现象并存。应结合当地医疗机构的诊疗量、收入支出等情况科学配置与管理医疗设备。Objective To describe the utilizations of 7 types common imaging equipment and analyze its related factors in 9 demonstration area/county medical institutions in Liaoning province and to provide objective evidence for the scientific allocation and management of local medical equipment.Methods The self-made questionnaires were used to collect the information on the quantity,brand,annual inspections,medical institutions’treatment and income and expenditure of 7 types of commonly used equipment at all levels of hospitals,and compare and analyzed the correlation.Results A total of 417 related equipments were investigated,and finally 348 were included in the analysis(83.5%).There is a large gap in the number of annual inspections of equipment in different levels of medical institutions,showing a successively downward trend of tertiary,secondary and primary medical institutions.91.7% of CT machines were severely overutilized in tertiary medical institutions;CT underutilization and overutilization coexisted in secondary medical institutions(27.8% overutilized and 5.6% underutilized),and 33.3% of magnetic resonance imaging(MRI)was overutilized in secondary medical Institutions.The number of annual inspections of digital radiography(DR),ultrasound equipment were significantly positively correlated with the number of people served by medical institutions,the actual number of open beds,the annual number of emergency outpatients,the number of first consultations,the total annual medical service income,the annual equipment diagnosis and treatment income,and the annual equipment maintenance and expenditure expenses.The number of annual inspections of imported brands of DR and ultrasound equipment was significantly higher than that of domestic brands(P<0.001).There was no statistical difference in the number of annual inspections of equipment in different purchase years.Conclusion The number of annual inspections of imaging equipment at different levels of medical institutions shows a downward trend in the order of tertiary,s

关 键 词：影像设备 利用水平 设备配置 年检查人次数 相关因素 

分 类 号：R197.39[医药卫生—卫生事业管理]