摘要
目的:了解我国136家三级公立医院防御性医疗检查存在的普遍情况及动态变化,并为减少防御性医疗提出建议。方法:利用2016-2018年连续三年"进一步改善医疗服务行动计划"第三方评估项目组在全国31个省(自治区、直辖市)和新疆生产建设兵团的136家三级公立医院每年近四万医护人员问卷调查资料,分析他们对防御性医疗检查普遍程度的认知情况及变化趋势。结果:三年间,医护人员对"为了避免医疗纠纷,医生做不必要的检查是普遍现象"这一条目的总体同意率分别为13.1%、24%和16.3%,其中医生对这一条目的同意率分别为16%,28.4%,21.6%,护士对这一条目的同意率分别为10.3%,20.3%,12.1%,医生的同意率普遍高于护士。结论:与国际上比较,三年间我国主要三级公立医院医护人员对防御性医疗检查存在的同意率总体不算高,但有上升趋势。
Objective: To understand the general situation and dynamic changes of defensive medical examinations in 136 major tertiary public hospitals in China. Methods: Since 2016, we conducted annual China Healthcare Improvement Evaluation Survey(CHIES) among nearly 40 000 health professionals from 136 tertiary public hospitals in 31 provinces across the country. This study focuses on the self-reported prevalence of one survey item "In order to avoid medical disputes, it’s common for doctors to provide unnecessary examinations" as an indicator of defensive medical examinations. Results: Between 2016-2018, the overall agreement among doctors and nurses on defensive medical examinations were 13.1%, 24% and 16.3% respectively. The doctors’ agreement rates(16%, 28.4%, and 21.6%) were higher than that of the nurses(10.3%, 20.3%, and 12.1%) and the upward trend of self-reported defensive medical examinations were apparent among both doctors and nurses. Conclusions: Compared with some international surveys, the agreement rates of health professionals on defensive medical examinations were not high in major tertiary public hospitals in China, but the upward trend over past three years raise concerns.
作者
张轩
马晶
吴依诺
杨思琪
裴晨阳
姜中石
曹曼
刘远立
ZHANG Xuan;MA Jing;WU Yinuo;YANG Siqi;PEI Chenyang;JIANG Zhongshi;CAO Man;LIU Yuanli(School of Public Health,Chinese Academy of Medical Sciences&Peking Union Medical College,46 Xizongbu Hutong,Dongcheng District,Beijing,China 100005;Department of Population Medicine,Harvard Medical School,Harvard Pilgrim Health Care Instituted,Boston,MA,USA 02215)
出处
《中国研究型医院》
2020年第1期46-51,160-166,共14页
Chinese Research Hospitals
基金
国家自然科学基金重点项目(项目编号:71532014)。
