根据超声质控指标探讨湖北省超声质控工作中面临的基本问题。

依据2019年全国医疗质量数据抽样调查结果，分析湖北省12家省部级医院、61家地市级医院和151家县区级医院质控数据，通过比较各级医院超声医师基本情况、结构质量指标（平均每日门诊、急诊、体检、住院超声检查人次；超声科医患比；超声科医师数与诊断仪器数比）、过程质量指标（平均住院超声检查预约时间、危急值通报例数）、结果质量指标（超声报告阳性率和超声诊断符合率）来反映湖北省224家不同隶属关系医院的超声质控现状。不同级别（省部级、地市级和县区级）医院上述超声质控指标比较，采用χ²检验或单因素方差分析，差异有统计学意义后再行两两间比较。

本次抽样调查的2556名超声医师在各级医疗机构中的平均数量、年龄、职称、学历构成比，差异均有统计学意义（F=89.218，χ²=44.830、17.039、1208.716，P均<0.05）；超声结构质量指标平均每日门诊、急诊、体检、住院超声检查人次，超声科医患比在各级医院中比较，差异均有统计学意义（F=55.990、40.390、21.877、54.520和5.740，P均<0.05）；而超声科医师数与诊断仪器数比在各级医院中比较，差异均无统计学意义（P均>0.05）；超声过程质量指标平均住院超声检查预约时间、危急值通报例数在各级医院中比较，差异均无统计学意义（P均>0.05）；超声结果质量指标超声报告阳性率在地市级医院和县区级医院中，差异有统计学意义（t=3.221，P<0.05），而超声诊断符合率在各级医院中，差异均无统计学意义（P均>0.05）。

湖北省不同隶属关系医院在超声结构质量指标中存在一定差异，尤其是超声医师学历和年龄构成比，积极加强人才队伍建设，重视超声过程和结果质量指标，建立完善的质控体系将对提高我省超声诊断水平发挥重要作用。

To explore the basic problems faced in the ultrasonic quality control in Hubei Province.

According to the sample survey results of national medical quality data in 2019, the quality control data of 12 provincial and ministerial-level hospitals, 61 city-level hospitals, and 151 county-level hospitals in Hubei Province were analyzed. The composition ratio of ultrasonic doctors, structural quality indicators (average daily ultrasound examination amount in outpatients, emergency cases, cases undergoing physical examination, and cases undergoing inpatient ultrasound examination; the ratio between the number of ultrasonic doctors to patients or diagnostic instruments), process quality indexes (mean appointment time of ultrasound examination and cases with ultrasound critical value report), and result quality indexes (positive rate of ultrasound reports and compliance rate of ultrasonic diagnosis) were compared among hospitals of different levels to investigate the current situation of ultrasound quality control in 224 hospitals. The ultrasonic quality control indicators in hospitals of different levels (provincial and ministerial, city, and county levels) were compared by chi-square test or one-way ANOVA. When the difference was statistically significant, pairwise comparison was made.

There were statistically significant differences in the average number, age, professional title, and educational background of 2556 ultrasonic doctors in hospitals of different levels (F=89.218, χ²=44.830, 17.039, 1208.716, P<0.05). Structure quality indexes including the average daily ultrasound examination amount in outpatients, emergency cases, cases of physical examination, cases of in-hospital ultrasound examination, and the ratio between the number of ultrasonic doctors and patients exhibited statistically significant differences among hospitals of different levels (F=55.990, 40.390, 21.877, 54.520, 5.740, P<0.05). However, there was no significant difference in the ratio between the number of ultrasonic doctors and diagnostic instruments among hospitals of different levels (P>0.05). There were no statistically significant differences in the average inpatient ultrasound appointment time and the cases with ultrasound critical value report among hospitals of different levels (P>0.05). There were statistically significant differences in the positive rate of ultrasound reports between city-level and county-level hospitals (t=3.221, P<0.05), while the compliance rate of ultrasound diagnosis showed no statistically significant difference among hospitals of different levels (P>0.05).

There are some differences in the structural quality indicators among hospitals of different levels in Hubei Province, especially the ratio of educational background and age of the ultrasonic doctors. Strengthening the construction of ultrasonic doctor team, paying attention to the quality control indexes of ultrasonic process and results, and establishing a perfect quality control system play an important role in improving the ultrasonic diagnosis level in Hubei Province.