上海市社区卫生服务中心医学检验基本项目谱和拓展项目谱建立的混合研究  

Establishment of basic tests and extended tests list for clinical laboratories in Shanghai community health service centers

作　　者：王茜青 夏卫 沈雪花 刁端勤 陈亮 顾锦松 石磊 陈晓敏 王永红 施美芳 高淑龙 车焱 沈梅芳[5] Wang Xiqing;Xia Wei;Shen Xuehua;Diao Duanqin;Chen Liang;Gu Jinsong;Shi Lei;Chen Xiaomin;Wang Yonghong;Shi Meifang;Gao Shulong;Che Yan;Shen Meifang(Clinical Laboratory,Puxing Community Health Service Center of Pudong New District,Shanghai 200129,China;Clinical Laboratory,Shimen Erlu Subdistrict Community Health Service Center of Jing′an District,Shanghai 200041,China;Clinical Laboratory,Tangwai Community Health Service Center of Fengxian District,Shanghai 201408,China;Clinical Laboratory of Changqiao Subdistrict Community Health Service Center of Xuhui District,Shanghai 200231,China;Clinical Laboratory,Huacao Community Health Service Center of Minhang District,Shanghai 201107,China;Clinical Laboratory,Zhongxing Town Community Health Service Center of Chongming District,Shanghai 202163,China;Clinical Laboratory,Guangzhonglu Community Health Service Center of Hongkou District,Shanghai 200083,China;Clinical Laboratory,Jiangzhen Community Health Service Center of Pudong New Area,Shanghai 201202,China;Clinical Laboratory,Yinhang Community Health Service Center of Yangpu District,Shanghai 200438,China;Clinical Laboratory,Youyi Subdistrict Community Health Service Center of Baoshan District,Shanghai 201999,China;Clinical Laboratory,Zhujing Community Health Service Center of Jinshan District,Shanghai 201599,China;Shanghai-MOST Key Laboratory of Health and Disease Genomics,NHC Key Lab of Reproduction Regulation,Shanghai Institute for Biomedical and Pharmaceutical Technology,Shanghai 200237,China)

机构地区：[1]上海市浦东新区浦兴社区卫生服务中心检验科,上海200129 [2]上海市静安区石门二路街道社区卫生服务中心检验科,上海200041 [3]上海市奉贤区奉城镇塘外社区卫生服务中心检验科,上海201408 [4]上海市徐汇区长桥街道社区卫生服务中心检验科,上海200231 [5]上海市闵行区华漕社区卫生服务中心检验科,上海201107 [6]上海市崇明区中兴镇社区卫生服务中心检验科,上海202163 [7]上海市虹口区广中路街道社区卫生服务中心检验科,上海200083 [8]上海市浦东新区江镇社区卫生服务中心检验科,上海201202 [9]上海市杨浦区殷行社区卫生服务中心检验科,上海200438 [10]上海市宝山区友谊街道社区卫生服务中心检验科,上海201999 [11]上海市金山区朱泾社区卫生服务中心检验科,上海201599 [12]上海市疾病与健康基因组学重点实验室、国家卫生健康委员会计划生育药具重点实验室、上海市生物医药技术研究院,上海200237

出　　处：《中华全科医师杂志》2023年第10期1017-1024,共8页Chinese Journal of General Practitioners

基　　金：上海市社区卫生协会2021年社区科研项目(SWX21M02)。

摘　　要：目的制定上海市社区卫生服务中心检验基本项目谱和拓展项目谱。方法采用混合研究方法,于2022年9—12月,对上海市所有247家社区卫生服务中心医学检验项目开展现状进行问卷调查;分层随机抽取区卫健委领导、社区卫生服务中心管理者、家庭医生及社区就诊患者,定性访谈其对社区医学检验的职能定位、服务能力建设及检验服务需求,在此基础上形成检验项目意见征询表,纳入31名本市社区医学检验相关领域的管理人员和专家学者,采用德尔菲法以及专家讨论会对各检验指标进行评分,形成社区医学检验项目的基本项目谱和拓展项目谱。结果发放调查问卷共247份,回收192份,回收率77.7%。上海市社区卫生服务中心共开展了132个检验项目。结合定性访谈结果,形成涵盖94个检验项目的意见征询表。采用德尔菲法对上海市31名检验相关管理者和专家进行2轮调查,专家平均权威系数为0.90,以该系数为权重对专家评分进行加权平均后,45项(47.9%)评分>7分,38项(40.4%)评分在5~7分之间,11项(11.7%)评分<5分。在此基础上,经专家研讨,最终48个检验项目列入社区医学检验基本项目谱,46个检验项目列入拓展项目谱。结论建议上海市所有社区卫生服务中心医学检验应包括48项基本检验项目,有条件和服务需求的社区卫生服务中心可从46项拓展项目谱中选择所需的项目进行扩展。ObjectiveTo develop a list of basic and expanded medical laboratory tests in community health service centers in Shanghai.MethodsThe status quo of human and equipment resource allocation,the test items and quality control currently performed,the perspectives of various stakeholders,the capacity building of community clinical laboratory in community health service centers in Shanghai were investigated by quantitative survey and qualitative interview;and the rating scores of each test item were assessed by expert consultation using Delphi method.The expert focus discussion was conducted,and each test item was rated and classified.Finally a list of the basic tests and expanded tests in clinical laboratories of community health service center was developed.ResultsA total of 247 questionnaires were distributed and 192(77.7%)were answered.A list of 94 laboratory test items was screened out based on the questionnaire survey of the laboratories of the community health centers.Thirty one experts in the relevant areas were invited to rate the test items,the average authority coefficient of experts was 0.90,with which the weighted average of the expert ratings was made.There were 45(47.9%)items scored 7 or higher,38(40.4%)scored between 5 and 7,and 11(11.7%)scored less than 5.Based on the results of the expert focus discussion,48 items were recommended as the basic tests and 46 items as the extended tests.ConclusionIn this study a list of tests recommended to clinical laboratories in Shanghai community health service centers has been developed,which contains 48 basic tests and 46 extended tests.

关 键 词：社区卫生中心 问卷调查 定性研究 检验项目 

分 类 号：R197[医药卫生—卫生事业管理]