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[与预防性目的相关的工人健康检查的质量及法规遵循情况]

[Quality and compliance with the regulations of workers'health examinations in relation to their preventive purpose].

作者信息

Rodríguez-Jareño Mari Cruz, Molinero Emilia, De Montserrat Jaume, Vallès Antoni, Aymerich Marta

机构信息

Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain.

出版信息

Arch Prev Riesgos Labor. 2016 Jul-Sep;19(3):146-65. doi: 10.12961/aprl.2016.19.3.02.

DOI:10.12961/aprl.2016.19.3.02
PMID:27378501
Abstract

OBJECTIVE

To analyze whether examinations for health surveillance in Catalonia are carried out with a high enough degree of quality as to comply with the preventive aim of the regulations, and to identify potential differences by type of prevention service.

METHOD

Qualitative and quantitative techniques. Body of data: Spanish regulations related to health surveillance, and a self-reported questionnaire answered by occupational health professionals who performed health examinations in their usual practice. Content analysis of regulations, identifying concepts, and linking them to survey questions. Quality criteria were established for each concept, referring to the minimum that must be met to ensure that the professional practice can be of quality; quality indicators (percentage of professionals whose practice met the quality criteria) were calculated globally and by type of prevention service; and quality standards (fulfilment of quality criteria by 75% or more of the professionals) were set.

RESULTS

The concepts identified were: availability of clinical and exposure information, job-specificity, identification of workers with special susceptibilities, referral to mutual insurance companies for appropriate diagnosis and treatment, development of preventive proposals, and professional independence and non detriment for workers. Quality indicators ranged between 0 and 88%. None of the concepts globally reached the quality standard.

CONCLUSIONS

The quality of health examinations performed for health surveillance in Catalonia, doesn't seem to be high enough as to comply with the preventive aim of the regulations. The situation is worse in external prevention services.

摘要

目的

分析加泰罗尼亚地区健康监测检查的开展质量是否足以符合法规的预防目标,并按预防服务类型识别潜在差异。

方法

采用定性和定量技术。数据主体:与健康监测相关的西班牙法规,以及由在日常工作中进行健康检查的职业健康专业人员自行填写的问卷。对法规进行内容分析,识别概念并将其与调查问题相关联。为每个概念制定质量标准,指确保专业实践具备质量必须满足的最低要求;计算总体及按预防服务类型划分的质量指标(实践符合质量标准的专业人员百分比);设定质量标准(75%或更多专业人员符合质量标准)。

结果

识别出的概念有:临床和接触信息的可获取性、工作特异性、特殊易感性工人的识别、转介至互助保险公司进行适当诊断和治疗、预防性建议的制定,以及专业独立性和对工人无害。质量指标在0%至88%之间。总体而言,没有一个概念达到质量标准。

结论

加泰罗尼亚地区为健康监测进行的健康检查质量似乎不足以符合法规的预防目标。外部预防服务的情况更糟。

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