Bibbolino C, Cristofaro M, Lauria F N, Petrecchia A, Vimercati F, David V
UO di Diagnostica per Immagini, Istituto Nazionale per le Malattie Infettive, Rome, Italy.
Radiol Med. 2001 Nov-Dec;102(5-6):391-6.
To comparise three methods for assessing the productivity of radiological services: a) simple count of radiological examinations, b) method proposed by SNR-SAGO-SIRM, c) method used by Regione Emilia Romagna (RER) to evalutate the characteristics of these methods and to find a common method of estimate.
On the radiological examinations performed at our unit over a period of 12 months were recorded. The different types of examinations were clustered into five homogenous groups (general radiology, ultrasound, barium examinations, CT, MRI). The data were assessed by a) number of examinations/hour per radiologist, b) score/hour according to the SNR-SAGO-SIRM method and c) score/hour according to the RER method, and then compared for the percentage of the single aggregates.
a) The total number of examinations was 26,776 with 40% being accounted for by general radiology; mean numbers of examinations our ranged from 2.43 (August) to 4.20 (March). b) The total score according to the SNR-SAGO-SIRM method was 67,054. The radiologist weight per hour ranged from 6.37 (August) to 9.67 (May). Ultrasound was the most relevant examination in the unit accounting for 43% of total weight. c) The total score according to the RER method was 1,850,780. The radiologist weight per hour ranged from 159 (August) to 316 (April). CT was the most relevant examination (51% of total weight).
According to the simple count of examinations, general radiology and ultrasound were the most relevant examinations together accounting for 75% of examinations, i.e. 40% and 35% respectively, whereas by SNR-SAGO-SIRM standards the two techniques represent 19% and 45% respectively. The simple count method therefore fails to give adequate weight to technologically advanced imaging technique. The SNR-SAGO-SIRM method adequately takes into account the combination of patient-number and patient weight. The RER method gives excessive weight costly technology as it considers the total weight of the examination and not only the radiologist's activity.
比较三种评估放射科服务生产率的方法:a)放射检查的简单计数;b)SNR-SAGO-SIRM提出的方法;c)艾米利亚-罗马涅大区(RER)用于评估这些方法特征并寻找通用估计方法所使用的方法。
记录了在我们科室进行的为期12个月的放射检查。不同类型的检查被归为五个同质组(普通放射学、超声、钡剂检查、CT、MRI)。数据通过以下方式进行评估:a)每位放射科医生每小时的检查次数;b)根据SNR-SAGO-SIRM方法计算的每小时得分;c)根据RER方法计算的每小时得分,然后比较单个汇总的百分比。
a)检查总数为26776次,其中普通放射学占40%;我们这里每小时的平均检查次数从2.43(8月)到4.20(3月)不等。b)根据SNR-SAGO-SIRM方法计算的总分为67054分。每小时放射科医生的权重从6.37(8月)到9.67(5月)不等。超声是科室中最相关的检查,占总权重的43%。c)根据RER方法计算的总分为1850780分。每小时放射科医生的权重从159(8月)到316(4月)不等。CT是最相关的检查(占总权重的51%)。
根据检查的简单计数,普通放射学和超声是最相关的检查,共占检查总数的75%,即分别占40%和35%,而按照SNR-SAGO-SIRM标准,这两种技术分别占19%和45%。因此,简单计数方法未能充分权衡技术先进的成像技术。SNR-SAGO-SIRM方法充分考虑了患者数量和患者权重的综合因素。RER方法过度重视成本高昂的技术,因为它考虑的是检查的总权重,而不仅仅是放射科医生的工作量。