Johns David P, Burton Deborah, Walters Julia A E, Wood-Baker Richard
Cardio-Respiratory Research Group, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Respirology. 2006 May;11(3):292-8. doi: 10.1111/j.1440-1843.2006.00851.x.
Despite the lack of data, it is believed that spirometry is underutilized in general practice. The aim of the present study was to determine the availability of spirometry and the level of spirometry training in general practice throughout Australia and compare with international data.
In total, 5976 general practices throughout Australia were sent a questionnaire requesting details of spirometer ownership, usage and the level and source of spirometry training. To exclude response bias, a follow-up telephone survey was conducted of 160 practices that did not respond to the initial survey.
Of practices 19.5% (1125) responded to the initial survey with 64.2% (722) of these owning a spirometer and 83.9% in the follow-up sample. Common reasons for not owning a spirometer were equipment cost (53.3%) and insufficient remuneration (32.8%). Most practices (67.0%) performed one or more tests per week. Practices commonly used spirometry to diagnose (89.5%) and manage (93.9%) asthma, assess breathlessness (83.4%) and to detect and manage other diseases such as COPD (77.7%). Spirometer accuracy was never checked using a syringe 77.8% of practices and 40% did not test a healthy subject as part of their quality assurance programme. Spirometry training was received most commonly through courses run by general practice organizations (38.2%), and the duration of training courses was <2 h in 40% of cases.
Despite high spirometer ownership in general practice, the frequency of use is low. Low rates of verification of spirometer accuracy and performance suggest the need for reliable, stable spirometers to be available to general practitioners. Regular and more comprehensive training in spirometry is needed.
尽管缺乏相关数据，但人们认为肺功能测定法在全科医疗中未得到充分利用。本研究的目的是确定澳大利亚全科医疗中肺功能测定法的可用性以及肺功能测定培训水平，并与国际数据进行比较。
向澳大利亚各地的5976家全科诊所发送了一份问卷，询问肺量计的拥有情况、使用情况以及肺功能测定培训的水平和来源。为排除应答偏差，对160家未回复初始调查的诊所进行了后续电话调查。
19.5%（1125家）的诊所回复了初始调查，其中64.2%（722家）拥有肺量计，后续样本中的这一比例为83.9%。不拥有肺量计的常见原因是设备成本（53.3%）和报酬不足（32.8%）。大多数诊所（67.0%）每周进行一次或多次检测。诊所通常使用肺功能测定法来诊断（89.5%）和管理（93.9%）哮喘、评估呼吸急促（83.4%）以及检测和管理其他疾病，如慢性阻塞性肺疾病（77.7%）。77.8%的诊所从未使用注射器检查肺量计的准确性，40%的诊所未将检测健康受试者作为其质量保证计划的一部分。肺功能测定培训最常见的是通过全科医疗组织举办的课程（38.2%），40%的培训课程时长小于2小时。
尽管全科医疗中肺量计的拥有率较高，但使用率较低。肺量计准确性和性能的验证率较低，这表明需要为全科医生提供可靠、稳定的肺量计。需要进行定期且更全面的肺功能测定培训。
