摘要
目的了解我国县级医院慢性阻塞性肺疾病(简称慢阻肺)诊治及管理能力现状。方法本研究由中国县域医院院长联盟主导,于2021年对县域范围内全国24个省份,633所二级及以上医院进行问卷调查,根据被调查医院2020年度实际情况进行填写,主要包括诊治、非药物治疗、康复、综合管理等方面。医院级别分为二级或三级,医院性质分为公立或民营,医院类别分为综合或专科,经济地带分为东部、中部或西部。通过问卷内容探索我国县级医院慢阻肺相关诊治及管理情况的影响因素。结果本次调查共回收问卷633份,去掉信息填写有误及空缺共计26份,最终共纳入607份,其中二级医院425家,三级医院182家;公立医院591家,民营医院16家。三级医院呼吸专科门诊、慢阻肺专病门诊、门诊综合诊疗室、呼吸专科普通病房、重症监护病房开设率均显著高于二级医院(94.5%比78.4%、51.1%比32.7%、79.7%比67.3%、84.6%比59.8%、78.6%比61.9%)(均P<0.01),肺功能检查及支气管舒张试验开展率也均显著高于二级医院(均P<0.05)。不同医院级别、医院性质、医院类别、经济地带间在吸入用支气管舒张剂、祛痰类药物配备率上差异均无统计学意义(均P>0.05),但二级医院三联吸入用支气管舒张剂配备率较低。综合医院疫苗接种开展率显著高于专科医院(52.7%比28.1%,P=0.010),三级医院戒烟指导开展率显著高于二级医院(98.4%比94.4%,P=0.031)。三级医院康复开展率显著高于二级医院(79.7%比61.9%,P<0.001)。慢阻肺长期管理开展率三级医院显著高于二级医院,公立医院显著高于民营医院(80.2%比61.2%和68.2%比18.8%)(均P<0.001)。结论我国县域医院在慢阻肺诊治能力上总体表现较好,但在非药物治疗、康复、综合管理上还有待进一步提高,医院级别是影响慢阻肺管理能力的主要因素,同时医院性质、医院类别的影响主要体现在科室建设及
Objective To understand the current management status of chronic obstructive pulmonary disease(COPD)in county-level hospitals in China from 2020 to 2021.Methods This survey was led by the China Association of County Hospital President.In 2021,a questionnaire survey was conducted on 633 secondary and tertiary hospitals from 24 provinces,and the questionnaire was filled out according to the actual situation of the hospital in 2020,including diagnosis,treatment,rehabilitation and comprehensive management of COPD.The nature of the hospital was divided into public or private.The type of hospital was divided into general or specialist.The economic zones was divided into eastern,central or western.Through the content of the questionnaire,the influencing factors of the diagnosis,treatment and management capabilities of COPD in county-level hospitals were explored.Results A total of 633 questionnaires were collected in this survey,and 26 were removed due to the incorrect information or information loss.Thus,a total of 607 questionnaires were finally included in this survey,including 425 secondary hospitals and 182 tertiary hospitals;591 public hospitals and 16 private hospitals.For the capabilities of diagnosis and treatment,the tertiary hospital was significantly better than the secondary hospital on the availability of respiratory outpatient clinics,COPD outpatient clinics,outpatient comprehensive clinics,respiratory ward and intensive care unit(ICU)(94.5%and 78.4%,51.1%and 32.7%,79.7%and 67.3%,84.6%and 59.8%,78.6%and 61.9%,respectively)(all P<0.01).In terms of lung function test and bronchodilation test,tertiary hospitals performed significantly better than secondary hospitals(P<0.05).There was no difference in availability of inhaled bronchodilators and expectorant drugs among different hospital levels,nature,type,and economic zones(P>0.05).However,the proportion of hospitals with available triple inhalation drugs was lower in secondary hospitals than tertiary hospitals.For the non-drug treatment,the proportion of gen
作者
唐星瑶
黄可
陈昉园
李薇
吴建忠
杨汀
Tang Xingyao;Huang Ke;Chen Fangyuan;Li Wei;Wu Jianzhong;Yang Ting(China-Japan Friendship Clinical Medical College,Capital Medical University,Beijing 100069,China;Department of Pulmonary and Critical Care Medicine,Center of Respiratory Medicine,China-Japan Friendship Hospital National Center for Respiratory Medicine,Beijing 100029,China;School of Clinical Medicine,Tsinghua University,Beijing 100084,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2022年第4期222-228,共7页
Chinese Journal of Health Management
基金
中国医学科学院中央级公益性科研院所基本科研业务费项目(2019TX320005)
中国医学科学院医学与健康科技创新工程项目(2020-I2M-2-008,2021-I2M-1-049)。
关键词
肺疾病
慢性阻塞性
县域医院
管理
Pulmonary disease,chronic obstructive
County hospitals
Management
