2012-2013年北京市海淀区放射卫生量化分级监督管理情况对比分析

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。

Comparative analysis of the supervision quantization and classifying management on radiation health between 2012 to 2013 in Haidian district of Beijing

The Objective is to find out problems of the management of the radiation medical institutions in Haidian district, and to find the key points of supervision in further. The research take the methods of carrying out a general survey on institutions with radiation medical treatment permit between 2012 and 2013, by the form of activities to quantify rating in Haidian district. The results found that 269 and 257 medical institutions were surveyed in 2012 and 2013. Compared with 2012, the proportion of class A units increased from 30. 1% to 72% in 2013. The number and the proportion of class C and D units has dropped significantly. Class A units of the primary medical institutions has the largest increased percentage, and class C units of the tertiary hospitals has the largest reduction ratio. Class C and D units accounted for the largest proportion of all medical institutions in the primary medical institutions. The qualified rates of the three major items, including health management, radiology personnel certification and workplace were low （56.5%, 61% and 64.7%, respectively）. However, the qualified rates had been greatly improved in 2013 （81.3%, 81.0% and 83.7%, respectively） In addition to the qualified rates of personal dose monitoring management and construction project management（ 71.6 % and 70.8 %, respectively）, the qualified rates of the other eight management projects were more than 80%. The results shows that primary medical institutions and tertiary hospitals are most effective following quantitative classification management. Personal dose monitoring management and construction project management are the key points of supervision in further.