To investigate the current status of quality control indicators and medical service quality in ultrasound medical departments of secondary and tertiary hospitals in Hainan Province, in order to provide reference for the continuous improvement and enhancement of ultrasound diagnostic quality.

The Hainan Ultrasound Medical Quality Control Center collected data on ultrasound diagnostic quality control indicators from 46 secondary and tertiary hospitals in Hainan Province (including 21 secondary hospitals and 25 tertiary hospitals) from January 1, 2024 to December 31, 2023. The indicators investigated included structural quality analysis indicators (monthly average workload of ultrasound physicians, ultrasound instrument quality inspection rate, ultrasound doctor-patient ratio, and ratio of ultrasound physicians to diagnostic instruments), process quality analysis indicators (completion rate of inpatient ultrasound examination within 48 hours, completion rate of ultrasound critical value report within 10 minutes, qualification rate of ultrasound report writing, and classification rate of breast imaging reporting and data system (BI-RADS) for ultrasound report of breast lesions), and result quality analysis indicators (positive rate of outpatient ultrasound reports, positive rate of inpatient ultrasound reports, detection rate of major fatal fetal malformations in ultrasound screening, ultrasound diagnostic compliance rate, and accuracy rate of breast mass ultrasound diagnosis). The rank sum test was used to compare the differences in various indicators between secondary and tertiary hospitals, and P<0.05 was considered statistically significant.

In terms of structural quality analysis indicators, the average monthly workload of ultrasound physicians in tertiary hospitals was significantly higher than that in secondary hospitals [795.75 (551.86, 972.45) person times/month vs 461.63 (347.00, 597.23) person times/month, U=135.00, P=0.005], and the ultrasound doctor-patient ratio in tertiary hospitals was significantly lower than that in secondary hospitals [1.04 (0.86, 1.51) person times/10000 person times vs 1.80 (1.39, 2.40) person times/10000 person times, U=134.50, P=0.005]. There was no statistically significant difference in the quality inspection rate of ultrasound instruments, the number of ultrasound physicians, or the number of diagnostic instruments (P>0.05). Regarding process quality analysis indicators, the reporting rate of ultrasound critical values within 10 minutes [100 (100, 100)% vs 100.00 (100, 100)%, U=22.50, P=0.024] and the BI-RADS classification rate of breast lesions [99.46 (97.30, 100.00)% vs 95.06 (88.88, 99.12)%, U=130.50, P=0.003] were significantly higher in tertiary hospitals than in secondary hospitals. There was no statistically significant difference in the qualified rate of ultrasound report writing or the completion rate of inpatient ultrasound examination within 48 hours (P>0.05). With regard to quality analysis indicators, the positive rate of ultrasound reports in outpatient and emergency departments [76.75 (65.51, 81.96)% vs 64.86 (54.30, 72.21)%, U=153.00, P=0.016], the ultrasound diagnostic accuracy [92.08 (88.84, 94.34)% vs 85.30 (83.20, 90.44)%, U=116.50, P=0.009], the ultrasound diagnostic accuracy for breast masses [86.29 (79.03, 92.07)% vs 79.63 (76.12, 85.20, 90.47)%, U=103.00, P=0.046], and the detection rate of major fatal malformations in ultrasound screening [0.03 (0.00, 0.08)% vs 0.00 (0.00, 0.00)%, U=109.00, P=0.004] were significantly higher in tertiary hospitals than in secondary hospitals. There was no significant difference in the positive rate of in-patient ultrasound reports in secondary and tertiary hospitals (P>0.05).

There are differences in multiple ultrasound quality control indicators between secondary and tertiary hospitals in Hainan Province. Based on the development status of ultrasound departments in secondary and tertiary hospitals in Hainan Province, especially the low compliance rate of ultrasound diagnosis in secondary hospitals compared to tertiary hospitals, the Hainan Ultrasound Medical Quality Control Center will further improve the quality control system, procedures, standards, and plans, and carry out quality control and improvement work in a standardized manner to achieve standardization and homogenization of ultrasound medicine in Hainan Province.