辽宁省基层医疗机构服务能力评价相关设备配置和使用情况调查

目的了解辽宁省基层医疗机构与其功能定位相匹配的医疗设备配置和使用情况,为当地卫生健康行政部门管理调控基层医疗设备提供参考数据。方法调查对象包括辽宁省9个示范区/县辖区内所有社区卫生服务中心和乡镇卫生院。利用自编调查表,采用自填问卷形式对各医疗机构主管医疗设备的负责人进行问卷调查。结果34家社区卫生服务中心和81家乡镇卫生院纳入分析(86.5%)。除生化分析仪外,社区卫生服务中心和乡镇卫生院的各类相关设备配备数量水平相当,均处于较低水平,尤其DR、血液分析仪、尿液分析仪和血凝仪的配置率较低,27.8%的机构认为由于"设备数量不足"导致不能满足日常需求;38.4%的设备超过了折旧年限且乡镇卫生院占比更高(P=0.004),51.3%的机构认为由于"设备陈旧或水平不能满足需求"导致不能满足日常需求,客观指标与主观认知结果一致。此外,和社区卫生服务中心比较,更多的乡镇卫生院认为由于"技术人员水平不能满足诊疗需求"(33.8%vs.8.3%,P=0.006)和"缺乏操作人员"(47.3%vs.25.0%,P=0.042)导致设备使用不能满足日常需求,并存在更多的利用率低下的问题。两类基层医疗机构不能满足需求的前三位设备均为DR、超声和CT。结论辽宁省基层医疗机构设备配置和使用存在设备配置率和配置数量不足、设备陈旧、相关技术人员紧缺或技术水平有限、设备利用率低下等问题,且乡镇卫生院较社区卫生服务中心更为突出。当地卫生健康行政部门应针对上述问题进行有效的管理调控。

Investigation on Configuration and Usage of Equipment Matching Service Capacity Evaluation of Primary Medical Institutions in Liaoning Province

Objective To understand the configuration and use of medical equipment matching the functional positioning of primary medical institutions in Liaoning province,and to provide reference data for the management and regulation of primary medical equipment by local health and health administrative departments.Methods Primary medical institutions in the nine demonstration zones/counties of Liaoning Province were investigated.A self-made questionnaire was used to conduct a questionnaire survey among persons who was in charge of medical equipment of medical institutions.Results A total of 34 community health service centers and 81 township health centers were included in the analysis(86.5%).Except to biochemical analyzers,the number of various types of related equipment in community health service centers and township health centers was similar,and they were all at a low level.In particular,the deployment rates of DR,blood analyzers,urine analyzers,and hemagglutinators were low.There were 27.8%of institutions believed that daily needs could not be met due to"insufficient number of equipment",and 38.4%of equipment exceeded the depreciation period and the proportion of township health centers was higher(P=0.004).There were 1.3%of institutions believed that daily needs could not be met due to"stale equipment or inadequate level of demand".In addition,compared with community health service centers,more township health centers believed that"the level of technical staff cannot meet the needs of diagnosis and treatment"(33.8%vs.8.3%,P=0.006)and"lack of operators"(47.3%vs.25.0%,P=0.042)leaded to equipment failure to meet daily needs and low utilization.The top three devices that could not be met by primary medical institutions were DR,ultrasound,and CT.Conclusion Liaoning’s primary medical institutions have some problems with equipment configuration and use,such as insufficient equipment configuration rate and number,outdated equipment,lack of technical personnel or limited technical level,and low equipment utilization.The township health centers are more prominent than community health service centers.The local health and health administrative department should carry out effective management and regulation on the above issues.