海南省地市及县级结核病定点医院服务能力分析

为了解海南省地市及县级结核病定点医院服务能力现状,笔者采用中国疾病预防控制中心统一设计的调查表,收集2019年海南省18家地市及县级结核病定点医院临床诊疗科室及实验室工作人员的学历、职称信息,以及该院结核病辅助检查项目开展情况。结果显示,18家地市及县级结核病定点医院中临床诊疗科室及实验室工作人员共347名,人均服务人口2.69万名,人均服务半径为5.68km;工作人员以本科学历为主(65.7%,228/347),硕士及以上者仅11名(3.2%),县、民族自治县工作人员中硕士及以上从业人员均低至0名。职称以初级或其他为主(53.0%,184/347),高级职称者仅占15.0%(52/347)。18家结核病定点医院中,开展数字X线摄影(DR)、CT或MRI检查者的占比分别为94.4%(17/18)、77.8%(14/18);但开展计算机X线摄影(CR)、结核菌素皮肤试验、γ干扰素释放试验、纤维支气管镜等检查的医疗机构占比均不高,分别为33.3%(6/18)、33.3%(6/18)、11.1%(2/18)、11.1%(2/18)。结核病诊疗工作人员按常住人口数及土地面积分布的基尼系数均为0.38。可见,海南省地市及县级结核病定点医院工作人员中高学历、高职称者较少,辅助检查项目开展不均衡,行政区划间人员配备仍需进一步加强。

Analysis of the service capability in city/county tuberculosis designated hospital in Hainan

To understand the status of service capability in city/county tuberculosis (TB) designated hospital in Hainan, the questionnaire design by Chinese Center for Disease Control and Prevention was used, the data of educational background and professional title of clinical staff and laboratory staff, as well as the usage of TB auxiliary examination from 18 city/county TB designated hospital in Hainan in 2019. It was found that there were 347 clinical and laboratory staff in the 18 city/county TB designated hospital. The average service population was 26900 per staff,and service radius of 5.68 km per staff. The mainly of the staff were bachelor (65.7%, 228/347), only 11 (3.2%) were master or higher. There was no staff with master’s degree or higher in counties/ethnic minority autonomous counties. Mainly staff were with junior or other professional titles (53.0%, 184/347), and the senior titles only accounted for 15.0% (52/347). The digital X-ray (DR), CT or MRI were carried out for 94.4% (17/18) and 77.8% (14/18), respectively from the 18 TB designated hospitals. However, the proportions of CR, tuberculin skin test, interferon gamma ralease assays and fiber bronchoscopy were not high, which were 33.3% (6/18), 33.3% (6/18), 11.1% (2/18) and 11.1% (2/18), respectively. The Gini coefficients of distribution based on the number of permanent residents and land area were both 0.38. It was found that the staff with high academic qualifications and high professional titles were not enough, the auxiliary tests were carried out imbalanced, the staff need to be further strengthened in city/county TB designated hospitals in Hainan.