昆士兰州一家大型三级医院超声心动图的使用情况及适宜使用标准的应用
Utilisation of echocardiography and application of the appropriate use criteria at a large tertiary hospital in Queensland.
作者信息
De Nardo Anthony, Niranjan Selvanayagam
机构信息
Department of Medicine Gold Coast Hospital and Health Service Parkwood Queensland Australia.
Department of Cardiology Gold Coast University Hospital Parkwood Queensland Australia.
出版信息
Australas J Ultrasound Med. 2016 May 20;19(2):64-70. doi: 10.1002/ajum.12014. eCollection 2016 May.
BACKGROUND
Medical imaging, including echocardiogram, is a major driver of escalating health-care costs.
AIMS
To examine the utilisation of transthoracic echocardiograms (TTEs) at a large tertiary hospital in Australia (Gold Coast Hospital and Health Service).
METHODS
We retrospectively looked at 500 transthoracic echocardiograms ordered sequentially. The stated reason for requesting the TTE was then classified into one of 98 indications constructed by the ACCF. These requests were then determined to be 'appropriate', 'inappropriate', or 'uncertain' as per the appropriate use criteria (AUC).
RESULTS
Overall, 443 TTEs were ordered appropriately (88.60%), 50 inappropriate (10.00%), and 8 met the criteria for uncertain. TTEs ordered by the cardiology team comprised of 131 appropriate (91.61%), 6 inappropriate (4.20%), and 6 uncertain (4.20%) indications. There were a higher percentage of appropriate TTE (93.23%) when performed on inpatients then when compared to those performed as an outpatient (82.91%).
CONCLUSIONS
Overall, Gold Coast Hospital and Health Service shows a good adherence to the AUC in keeping with similar studies in large hospitals overseas.
背景
包括超声心动图在内的医学成像技术是医疗保健成本不断攀升的主要推动因素。
目的
研究澳大利亚一家大型三级医院（黄金海岸医院与健康服务中心）经胸超声心动图（TTE）的使用情况。
方法
我们回顾性地查看了依次开具的500份经胸超声心动图检查申请。随后，将申请TTE的既定理由归类为美国心脏病学会基金会（ACCF）制定的98种适应症之一。然后根据适当使用标准（AUC）将这些申请判定为“适当”、“不适当”或“不确定”。
结果
总体而言，443份TTE申请开具得当（88.60%），50份不适当（10.00%），8份符合不确定标准。由心脏病学团队开具的TTE申请中，131份适应症适当（91.61%），6份不适当（4.20%），6份不确定（4.20%）。与门诊患者相比，住院患者进行TTE检查时，适当TTE的比例更高（93.23%对82.91%）。
结论
总体而言，黄金海岸医院与健康服务中心在遵循AUC方面表现良好，与海外大型医院的类似研究结果一致。
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