Márquez-Martín Eduardo, Soriano Joan B, Rubio Myriam Calle, Lopez-Campos Jose Luis
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Cátedra UAM-Linde, Madrid, Spain.
Int J Chron Obstruct Pulmon Dis. 2015 Aug 17;10:1633-9. doi: 10.2147/COPD.S86074. eCollection 2015.
The aim of this study is to evaluate the ability and practice of spirometry, training of technicians, and spirometry features in primary care centers in Spain, evaluating those located in a rural environment against those in urban areas.
An observational cross-sectional study was conducted in 2012 by a telephone survey in 970 primary health care centers in Spain. The centers were divided into rural or urban depending on the catchment population. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test that included the following topics: center resources, training doctors and technicians, using the spirometer, bronchodilator test, and the availability of spirometry and maintenance.
Although the sample size was achieved in both settings, rural centers (RCs) gave a lower response rate than urban centers (UCs). The number of centers without spirometry in rural areas doubled those in the urban areas. Most centers had between one and two spirometers. However, the number of spirometry tests per week was significantly lower in RCs than in UCs (4 [4.1%] vs 6.9 [5.7%], P<0.01). The availability of a specific schedule for conducting spirometries was higher in RCs than in UCs (209 [73.0%] vs 207 [64.2%], P=0.003). RCs were more satisfied with the spirometries (7.8 vs 7.6, P=0.019) and received more training course for interpreting spirometry (41.0% vs 33.2%, P=0.004). The performance of the bronchodilator test showed a homogeneous measure in different ways. The spirometer type and the reference values were unknown to the majority of respondents.
This study shows the differences between primary care RCs and UCs in Spain in terms of performing spirometry. The findings in the present study can be used to improve the performance of spirometry in these areas.
本研究旨在评估西班牙初级保健中心肺活量测定的能力与实践、技术人员培训及肺活量测定特征，比较农村地区与城市地区的初级保健中心。
2012年通过电话调查对西班牙970家初级卫生保健中心进行了一项观察性横断面研究。根据服务人口将这些中心分为农村或城市中心。该调查联系了负责肺活量测定的技术人员，包含36个与该测试相关的问题，涉及以下主题：中心资源、培训医生和技术人员、使用肺活量计、支气管扩张试验以及肺活量测定的可用性和维护。
尽管在两种环境下均达到了样本量，但农村中心（RCs）的回应率低于城市中心（UCs）。农村地区没有肺活量测定设备的中心数量是城市地区的两倍。大多数中心有一到两台肺活量计。然而，农村中心每周的肺活量测定测试次数显著低于城市中心（4[4.1%]对6.9[5.7%]，P<0.01）。农村中心进行肺活量测定的特定时间表的可用性高于城市中心（209[73.0%]对207[64.2%]，P=0.003）。农村中心对肺活量测定更满意（7.8对7.6，P=0.019），并且接受更多关于解读肺活量测定的培训课程（41.0%对33.2%，P=0.004）。支气管扩张试验的执行在不同方面表现出一致性。大多数受访者不知道肺活量计类型和参考值。
本研究显示了西班牙农村和城市初级保健中心在进行肺活量测定方面的差异。本研究结果可用于改善这些地区的肺活量测定执行情况。
