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找出北京市海淀区内开展放射诊疗工作的医疗机构在放射卫生管理中存在的问题,并为下一阶段海淀区卫生监督所的监督管理重点指明方向。方法:采用普查的方法,于2012年和2013年,用自制的《北京市海淀区医疗机构放射卫生量化分级表》对辖区内已取得《放射诊疗许可证》且开展放射诊疗活动的医疗机构进行量化评级。结果:(1)2012年和2013年分别调查了269和257家医疗机构。与2012年相比,2013年A级单位所占比例由30.1%提高到了72.0%;C级和D级单位数和构成比都有了很大程度的下降,差异具有统计学意义。(2)一级以下医疗机构中A级单位增加的比例和三级医疗机构C级单位减少的比例最大。一级及以下级别的医疗机构中的C、D级单位数占全部医疗机构的比例最大。(3)2012年量化分级情况中,卫生管理、放射人员证和工作场所三个大项合格率较低,合格率分别为56.5%、61.0%和64.7%;而2013年这三项的合格率均得到较大提高,分别为81.3%、81.0%和83.7%。(4)除个人剂量检测管理和建设项目管理的合格率分别为71.6%和70.8%外,2013年其他八项管理项目的合格率均达到80%以上。结论:三级和一级以下医疗机构实行量化分级监督管理最有成效;2013年海淀区放射卫生合格率反映出个人剂量检测和建设项目管理为下一年的监督管理重点。
Identify the existing problems in the radiological hygiene management of medical institutions conducting radiological diagnosis and treatment in Haidian District, Beijing and provide the direction for the supervision and management of Haidian District Health Authority in the next phase. Methods: By means of census, in 2012 and 2013, with self-made “Quantitative Classification Table of Radiation Health of Medical Institutions in Haidian District, Beijing”, the medical institutions that have obtained the “Radiological Examination and Licensing Certificate” Quantitative rating. Results: (1) 269 and 257 medical institutions were surveyed in 2012 and 2013 respectively. Compared with 2012, the proportion of Class A units increased from 30.1% to 72.0% in 2013; the number of Class C and Class D units and the composition ratio have dropped to a great extent, with statistically significant differences. (2) The proportion of Grade A units in tier-1 medical institutions below Grade-C is lower than that of tier-3 medical institutions. The number of C and D units in the medical institutions at the first grade and below accounted for the largest proportion of all medical institutions. (3) Among the quantitative grading cases in 2012, the pass rates of health management, radiological personnel cards and workplaces were relatively low, with the pass rates of 56.5%, 61.0% and 64.7% respectively; while the pass rates of these three items in 2013 They were greatly improved, respectively 81.3%, 81.0% and 83.7%. (4) In addition to the 71.6% and 70.8% pass rates for individual dose testing and construction project management, the other eight management projects passed the qualification rate of over 80% in 2013 respectively. Conclusion: It is most effective to implement the quantitative and hierarchical supervision and management of medical institutions under three levels and one below. The passing rate of radioactive hygiene in Haidian District in 2013 reflects the focus of individual dose detection and construction project management on the next year’s supervision and management.