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Objective:To study the healthcare level (HCL) in China and its influencing factors.Methods:By using the data reported in the China statistical yearbook published by the National Bureau of Statistics and in other public literature, HCL was calculated in terms of the number of population and physicians in the whole country and various provinces. Multiple regression was used to analyze the relationship between HCL and regional population, area, number of administrative divisions and gross domestic product (GDP). Pearson correlation analysis was applied to analyze the relationship between healthcare level and medical radiation frequency. Results:Since 2015, Chinese HCL value was lower than 1 000, but there were two provinces with HCL value greater than 1 000 in 2019. Population and GDP were the influencing factors for the HCL, with correlation coefficients of 0.416 and -0.583, respectively. There was a correlation between HCL and medical exposure frequency of Chinese population( r= -0.620, P=0.028). Conclusions:Chinese HCL value was 542 in 2020, but there has been great differences between various provinces. HCL as an indicator of medical exposure assessment needs further research in China.
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@#<b>Objective</b> To obtain the medical exposure frequency data of residents through a questionnaire survey on mobile phone networks in the community, and to analyze the main influencing factors. <b>Methods</b> A snowball sampling method was used to expand the sampling from medical staff in a county hospital to the community. The questionnaire included personal information such as occupation category, type of medical insurance, and education level as well as basic radiation-related knowledge and medical exposure type and frequency of respondents received in 2021. A logistic regression model was used to analyze the influencing factors of medical exposure. <b>Results</b> A total of 223 respondents were investigated, and 12.56% of them received radiological diagnosis and radiotherapy in 2021. The proportion of males receiving medical exposure was significantly higher than that of females (19.64% <i>vs</i> 10.18%). The likelihood of the person receiving medical exposure increased considerably with age, with the proportion of residents receiving medical exposure at 20, 30, 40, and 50 years of age being 6.25%, 7.95%, 19.23%, and 33.33%, respectively. Of persons who received medical exposure, 57.14% underwent CT scans. Persons participating in the new rural cooperative medical system were likely less to receive radiological diagnosis and radiotherapy than urban workers and residents (<i>OR</i> = 0.55, <i>CI</i>:0.13-2.23, <i>P</i> > 0.05). <b>Conclusion</b> Questionnaire survey in the community can obtain more information about the medical exposure of residents, and age and type of medical insurance are important factors affecting the frequency of medical exposure.
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Objective To investigate the basic situation of radiodiagnosis and radiotherapy institutions and the frequency of medical exposure in Fangshan District, Beijing, China. Methods A general survey using the questionnaire was conducted online to obtain the basic situation of the radiodiagnosis and radiotherapy institutions, the number of people in each type of radiodiagnosis and radiotherapy project, and the number of the usually resident population in the whole district in 2019, thus obtaining the frequency of medical exposure in each type of radiodiagnosis and radiotherapy project. Results There were 60 radiodiagnosis and radiotherapy institutions, 565 radiology staff, and 199 sets of radiodiagnosis and radiotherapy equipment in the whole district in 2019. The frequency of medical exposure was 521.29 per 1000 people, among which conventional medical diagnostic X-ray workers accounted for 301.79 per 1000 people (57.89%) and computed tomography workers accounted for 207.56 per 1000 people (39.82%). The number of tertiary hospitals accounted for 6.67% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed tomedical radiation in tertiary hospitals accounted for 52.25% of the total. The number of secondary hospitals accounted for 5.00% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed to medical radiation in secondary hospitals accounted for 27.83% of the total. Conclusion The distribution of medical exposure in Fangshan District is uneven. The radiodiagnosis and radiotherapy technology used is relatively single. Relevant departments should strengthen macroscopic readjustment and control, and formulate reasonable policies, so as to rationally allocate and effectively utilize medical and health resources.
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Objective:To develop and test a software which can get and count the medical exposure frequency automatically.Methods:This study was based on the investigation of the frequency of radiodiagnostic medical procedures in China over the past by reference to the experience gained from the Electronic Medical Record Sharing and Reporting System in Beijing. The core elements for collecting the number of medical procedures and radiodiagnostic categories were determined. The collection process was then designed and the collection program software was written in a way for deployment on the front-end computer system of a general hospital for trial.Results:The field table to collect the number of medical procedures and the corresponding data structure were generated, and the data collection and statistics of the above fields were realized based on the survey data of DR and CT diagnostic examination frequency in a hospital in 2021. It took 15 s on average, and the statistical result are consistent with the manual statistical result using RIS source table.Conclusions:The software can realize the automatic acquisition and reporting of the number of radiodiagnostic medical procedures in hospital on a regular basis, which is worth promoting.
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@#<b>Objective</b> To investigate the current status of application of resources on medical exposure in Dongying, China, and to provide fundamental data for setting up the health information management system of occupational radiation diseases and implementing health supervision and management strategies. <b>Methods</b> According to the requirements of monitoring program on radiation health of Dongying in 2021, a general survey was carried out in all medical institutions (other than dental clinics) providing radiodiagnosis and radiotherapy services by the field investigation method using the unified questionnaires and survey content, and a descriptive analysis was conducted on the results. <b>Results</b> There were 92 institutions of radiodiagnosis and radiotherapy in Dongying, 1112 radiation workers who accounted for 5.9% of all workers on duty, including 679 (61.1%) males and 433 (38.9%) females, and 364 pieces of radiation equipment, including 339 for X-ray diagnosis, 8 for radiotherapy, 2 for nuclear medicine, and 15 for interventional radiology. The allocation of personal protective equipment for interventional radiology staff in tertiary hospitals was higher than that in secondary hospitals, in which there were 0.36 and 0.23 pieces of lead-rubber aprons, 0.43 and 0.30 pieces of lead-rubber hats, 0.50 and 0.35 pieces of lead-rubber collars, 0.05 and 0 pairs of lead-rubber gloves, and 0.31 and 0.17 pairs of lead protection glasses per capita, respectively. The allocation rates of lead-rubber collars and lead protection glasses in the nuclear medicine staff were higher than those in the interventional radiology staff, with 0.63 collars and 0.88 pairs per capita, respectively. The annual frequency of medical exposure was calculated to be 864.3 person-times per 1000 population for radiodiagnosis and 5.2 patients per 1000 population for radiotherapy. <b>Conclusion</b> The allocation and application of resources on medical exposure in Dongying is unbalanced, so it is demanded to set up a health information management system of occupational radiation diseases for continuously mastering the application of medical exposure and adopting differentiated regulatory measures such as rating classification in Dongying.
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Objective To assess the medical radiation exposure frequency and find out the main factors related to the collective dose derived from X-ray diagnosis procedures. Methods A survey of 3 178 hospitals was conducted to collect the basic information such as types of medical radiation, allocation of radiological diagnosis and treatment devices, the frequency of radiologic examinations, etc. By using a stratified sampling method，36 hospital were selected and more specific details, including 26 types of diagnostic radiologic examinations, were collected to estimate the collective dose to the population in Hubei, combining with the previous literature. Results A total number of 6 843 radiological diagnosis and treatment devices were covered and 33 771 855 medical radiologic procedures were counted in this survey. The result showed a annual frequency of 569.79 examinations per 1 000 population for all types of procedures. A large variation was revealed among different areas and the highest area was with a 4-fold frequency of the lowest area. Although tertiary hospitals accounted for 4.40% of the total hospitals, 48.42% procedures were carried out in them. The collective effective dose from X-ray diagnosis in Hubei was 65 399.55man·Sv, and the average annual effective dose was 1.10mSv, while contribution from CT scans accounted for 86.90% of the dose. Conclusion The frequency of medical radiologic procedures presented a consistent increase in Hubei province, with a uneven development among hospitals from urban and rural areas, or from different regions, or from different levels. Among all types of X-ray examinations, CT scan frequency had the fastest growth rate and accounted for the major annual collective effective dose. In order to reduce the health risk from medical radiologic exposure, CT scan need to be applied more properly and the radiation dose per single CT scan need to be limited to a reasonable level.
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Objective:To investigate the current status of the radiodiagnosis and radiotherapy resources and medical exposure frequencies in Huai′an City.Methods:According to the monitoring data in the " Radiological Health Information Management Platform of Jiangsu Province" in 2020, a descriptive analysis was conducted on the personnel, equipment, and exposure frequencies in the institutes engaged in radiation-based diagnosis and treatment in Huai′an.Results:A total of 181 hospitals were investigated in 2020, including 7 tertiary hospitals(3.9%), 24 secondary hospitals(13.3%), 126 primary hospitals(69.6%), and 24 ungraded hospitals(13.3%). There were 1 397 radiation workers, including 948 males and 449 females, and 459 pieces of radiation equipment, including 420 for radio diagnosis, 13 for radiotherapy, 4 for nuclear medicine, and 22 for interventional radiology. The hospitals of different grades greatly differed in the number of radiation workers and equipment. There were 80.1, 20.9, 2.2, and 2.0 radiation workers and 15.7, 5.5, 1.4, and 1.6 pieces of radiation equipment in the tertiary hospitals, secondary hospitals, primary hospitals, and ungraded hospitals, respectively on average. There were 2 903 246, 27 648, 8 087, and 17 874 receiving radiodiagnosis, radiotherapy, nuclear medicine, and interventional radiology, respectively in 2020. The medical exposure frequencies in the whole city were calculated to be 599.50 per 1 000 population, including 334.59 treated with conventional X-rays, 239.82 receiving CT scan, 14.18 for breast and dentistry, 3.62 receiving interventional radiology, 5.61 treated with radiotherapy, and 1.69 receiving nuclear medicine.Conclusions:The radiodiagnosis and radiotherapy resources are unbalanced in the hospitals of different grades in Huai′an City. Therefore, it is necessary to pay more attention to the reasonable allocation of medical resources. Meanwhile, radiation workers in secondary hospitals may be more prone to job burnout. Facing the normalization of the prevention and control of COVID-19 epidemic, the supervision and management of radiological health should be strengthened to ensure the legitimacy of radiological diagnosis and radiotherapy and theoptimization of protection. The frequencies of medical exposure are consistent with the local economic level. To analyze the differences in medical exposure frequencies and predict the developmental trends in different regions, it is necessary to establish a more accurate prediction model.
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RESUMEN: Las exposiciones médicas con radiación ionizante son actualmente la principal fuente de exposición a la radiación artificial a nivel global, entre ellas, los exámenes dentales corresponden a uno de los más frecuentes. Para prevenir dosis innecesariamente altas a los pacientes durante estas exposiciones, la Comisión Internacional de Protección Radiológica (ICRP) recomienda la utilización de Niveles de Referencia para Diagnóstico (DRLs), como una herramienta efectiva de ayuda a la optimización de la protección radiológica en la exposición médica de pacientes. Dado que la legislación de Chile aún no ha incorporado el uso de los DRLs, el presente trabajo de revisión tuvo como objetivo analizar la publicación N° 135 de la ICRP para generar un documento que sirva de guía para los odontólogos, explicando de manera didáctica y en un lenguaje sencillo, pero técnico, los principales aspectos a tener en cuenta para establecer los DRLs en procedimientos de radiología dental.
SUMMARY: Currently exposure to ionizing radiation is currently the main source of exposure to artificial radiation worldwide, with dental examinations being one of the most frequent events. In order to prevent exposure of unnecessarily high doses in patients, the International Commission on Radiological Protection (ICRP) recommends the use of Diagnostic Reference Levels (DRLs), as an effective tool to help maximize protection from radiation during medical exposure of patients. Given that the Chilean legislation has not yet incorporated the use of DRLs, the purpose of this study was to analyze publication N° 135 of the ICRP to generate a document, to serve as a guide for dentists, didactically outlining in simple but technical language, the main aspects to consider when establishing DRLs in dental radiology procedures.
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Humans , Radiation Protection/standards , Radiography, Dental/methods , Radiation Dosage , Radiation Protection/methods , International Agencies , Practice Guideline , Radiation Exposure/prevention & control , Evaluation Studies as TopicABSTRACT
Objective: This study aims to estimate the annual doses for personnel categories following their exposure to ionizing radiation during their occupation in the external radiotherapy department of the Center of Oncology and Hematology (COH) at Mohammed VI Hospital in Marrakech.Materials and Methods:Operational dosimeters PACK MGP DMC3000 were used to measure the dose rates around the machines operating with ionizing radiation. In order to assess the reliability of the measurements made by these dosimeters, they were checked against measurements made at the same position by theInspector detector. The annual effective dosewas calculated by multiplying the average dose rate measured during a procedure by the overall treatment time throughout a year Results: Regarding the reliability checkof the measuring instrument, the recorded error is between 2 and 10% with an average of 7%. For personnel category A, the measured dose rate ranges from 0.066 to 0.083 μSv/h, with an average value of 0.075 μSv/h. For category B, it varies between 0.066 and 0.083 μSv, with an average value of 0.092 μSv/h. It is 0.074 μSv/h for category C. The annual dose for category A ranges from 0.089 to 0.113 mSv/year, with an average value of 0.101 mSv/year. For category B, it varies between 0.089 and 0.113 mSv/year, with an average value of 0.100 mSv/year. It is 0.100mSv/year for category C.Conclusion: The annual effective doses to personnel categories, assessed by this study, are very low compared to the regulatory standards set by the International Commission on Radiological Protection (ICRP). As a result, workers benefit from good radiation protection conditions within the Center of Oncology and Hematology at Mohammed VI Hospital in Marrakech
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Objective To study the frequency of diagnostic medical radiological examinations and the distribution of examinees in Jiangxi province by sampling investigation,including normal X-ray diagnosis,computed tomography (CT),interventional radiology.Methods Hospitals of different levels in Jiangxi province were chosen by the typical sampling method.Questionnaire was used in this study.Results There were more male examinees than female in diagnostic medical radiological examinations.For the distribution of age,the "0-" group accounted for the lowest and the "40-" group the highest proportion.The annual frequency in 2016 in Jiangxi was 543.07 examinations per 1 000 population for normal X-ray diagnosis,244.79 examinations per 1 000 population for CT scanning,6.28 examinations per 1 000 population for interventional radiology.Conclusions The frequency of diagnostic medical radiological examinations in Jiangxi has been increased rapidly which made a huge challenge for radiological protection.Therefore,the supervision and management of diagnostic medical radiological examinations should be enhanced and medical resources should be rationally allocated.
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Objective To obtain the information on the frequency of diagnostic X-ray examinations in Guangdong province in order to provide reference data for the rational application of diagnostic radiology.Methods A typical stratified sampling method was used to select 56 medical institutions in 7 districts in Guangdong province for the survey of the frequencies of diagnostic X-ray examinations.Multiple linear regression analysis was performed using the relevant variables of the surveyed sample (total number of hospitals,number of outpatients,number of inpatients,number of radiation workers,and number of diagnostic equipment).The dependent independent variables were fitted to the linear regression equation to estimate the frequency of routine diagnostic X-ray examinations and diagnostic CT examinations and the total frequency of diagnostic medical X-ray examinations in Guangdong province in 2016.Results By the largest percentage contribution,chest radiography accounted for 60.84％ of the routine diagnostic X-ray examinations,brain scans 28.03％ of diagnostic CT examinations,and cardiovascular interventions 48.83％ of interventional radiology.For the group of above 40 years old,the largest percentage contributions were,respectively,routine diagnostic X-ray examination 47.95％,diagnostic CT examinations 65.41％,and interventional radiology 75.64％.All types of medical X-ray examinations are concentrated in the tertiary and secondary hospitals.Based on this survey,the examination frequencies for 2016 in Guangdong were estimated to be,respectively,diagnostic X-ray examination 699 examinations per 1 000 population and CT diagnostic 231 examinations per 1 000 population,with the total of 992 examinations per 1 000 population.Conclusions This survey was completed to a limited degree and less investment.The results showed that the diagnostic radiology in Guangdong province is developing with increased frequencies,with wide varieties of X-ray examination types in the tertiary and secondary hospitals.Relevant competent defpartments should pay attention to strengthening the radiation protection of examined individuals and actively providing guidance on the correct and rational applicc ation of diagnostic radiology so as to achieve profit and avoid disadvantages.
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Objective To analyze the distribution characteristics and influencing factors of X-ray diagnostic imaging in Shandong province,and to estimate the application frequency of X-ray diagnostic imaging in the province,and provide data support for X-ray equipment.Methods A random sampliug method was used to extract 32 medical institutions as respondents from 10 prefecture-level cities in Shandong province.The basic information of medical institutions and the age,sex,examination and procedure of the subjects were analyzed.The distribution of the X-ray application was analyzed and estimated by using a multiple linear regression model.Results Totally 14 694 085 subjects were surveyed,and the proportion of male and female in the sample was not completely uniform.A total of 2 099 155 X-ray diagnostic information was collected in 2016,and the frequency of conventional radiography was the highest,accounting for 59.49％.The next was CT examination,accounting for 28.34％.The frequency of the two examinations showed an increasing trend with the age of subjects.For the total frequency of conventional diagnostic radiography and CT examination,the tertiary hospitals accounted for the highest proportion of the total,up to 52.13％,while the secondary hospitals accounted for the relatively low proportion of 30.09％,and the primary hospitals the lowest with 17.77％.The chest radiography had the highest proportion in conventional radiography accounting for 32.79％ of the total frequency of X-ray diagnostic imaging,and the head procedure had the highest proportion in CT examination,accounting for 10.07％ of the total frequency of X-ray diagnostic imaging.The fluoroscopy,mammography and dental radiography were mainly concentrated in the tertiary hospitals,and the primary hospitals had mainly radiography.Multiple linear regression models showed that the frequency of application of conventional X-ray diagnostic imaging (including radiography,fluoroscopy,dental radiography and mammography) was positively correlated with equipment quantity,number of outpatient and emergency patients,and tertiary hospitals (t=4.334,3.615,2.339,P＜ 0.05).CT examination was positively correlated with equipment quantity and the number of inpatient (t =2.167,2.595,P＜0.05).The frequency of conventional X-ray diagnostic imaging and CT examination in Shandong province were estimated about 491.17 examinations per 1 000 population and 258.17 examinations per 1 000 population respectively.Conclusions The frequency of X-ray exposure in Shandong province increased significantly compared with that during the " 9th Five-Year Plan" period.All relevant departments should take effective measures to strengthen medical radiation protection and reduce radiation risk.
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Objective To survey the frequency of medical X-ray diagnosis and estimate the medical exposure levels of Jiangsu province in 2016,so as to be able to improve effectively the protection against medical radiation exposure.Methods All medical institutions in the province were covered in the survey for their basic medical information by means of census method.Frequencies of diagnostic medical X-ray examination were studied using random sampling method in 31 medical institutions.A linear model was established by number of outpatients number of inpatients,number of staff and number of radiation workers to evaluate the medical examination frequency.Results A total of 9 248 pieces of medical X-ray diagnostic equipment by the end of 2016 in Jiangsu province,including 1 110 CT scanners.The total frequencies of diagnostic medical X-ray examination were estimated to be 911.45 examinations per 1 000 population,covering 239.25 per 1 000 for CT scanning.The number of medical X-ray diagnostic equipment increased by a factor of 0.8 while CT scanners by a factor of 3.6 compared to 1999.Medical X-ray diagnostic frequency raised by a factor of 3.2 while CT frequency by a factor of 15.1 compared with previous data.Conclusions The medical X-ray diagnostic frequencies in Jiangsu province was 1.9 times the value given in the UNSCEAR 2008 Report,close to those in some developed European countries.Compared with the study in 2015,the present study has made greater improvement in sampling technique for selection of hospitals and equipment,frequency estimation method and acquisition of influence factors.Estimates of medical X-ray diagnosis frequency are closer to actual level.Further improvement will be needed for the future survey,so as to further study medical exposure levels and to provide basic information for better patient protection.
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Objective To obtain the information on frequency of diagnostic medical X-ray examination and age distribution of examined individuals surveyed through samples from 12 hospitals in Inner Mongolia region to provide the basis for the optimization of medical exposure.Methods Stratified sampling method was used to select 12 hospitals in the region to survey the information of examined patients on sex,age and exposed location of patients undergoing medical X-ray examination in 2015 and 2016.Based on the information on number of inpatients,number of inpatients and total number of staff,the total frequency of medical X-ray examinations in the region for 2015 and 2016 was estimated by using multiple linear regression model.Results The survey showed that the total frequency of medical exposure was,in decreasing order,tertiary hospitals ＞ secondary hospitals ＞ primary hospitals,and meanwhile the general hospitals ＞ specialized hospitals.Values on frequency in general hospitals in 2015 and 2016 were 223 examinations per 1 000 population and 233 per 1 000 in conventional X-ray examination,96 per 1 000 and 125 per 1 000 in CT examination,1 per 1 000 and 2 per 1 000 in fluoroscopy,35 per 1 000 and 19 per 1 000 in dental radiology,1 per 1 000 and 2 per 1 000 in breast fluoroscopy in the region,respectively.Conclusions The frequency of radiological diagnosis and treatment in Inner Mongolia showed an rapid upward trend,but varied greatly dependent on the levels and types of medical institutions.Further surveys should be expanded with focuses on their comprehensiveness and relevancy.
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Objective To scale the frequencise of medical X-ray diagnosis based on the survey conducted in 58 hospitals to the all hospitals in Henan province,in order to make them available for providing the basis for reasonable application of diagnostic radiology.Methods Stratified sampling method was used to select medical institutions at different levels in 6 cities in the province as sample hospitals.The information of examined patients on sex,age,diagnostic type and exposure category were gathered and the results were analyzed.Results The sex ratio of male and female examined patients was close to 1∶1.The largest proportion,60.47％,of examined patients was from the age group of above 40 years old among the three age groups.Medical diagnositc medical X-ray examinations mainly include conventional X-ray photography and CT examination,accounting for 52.15％ and 40.31％,respectively.Chest examination contributed the largest propotions,23.84％,of conventional diagnositic X-ray examination and,13.25％,of CT examination respectively.CT examinations were mainly concentrated in the secondary and tertiary hospitals,accounting for 21.54％ and 72.99％ of the total CT examinations,respectively.Contrast examination,mammography and extracorporeal lithotripsy were concentrated in the tertiary hospitals,accounting for 77.82％,95.01％ and 100％ of the same type of examinations,respectively.Conventional photographic examinations were mainly conducted in primary hospitals,accounting for 74.56％ of all types of examinations in the primary hospitals.By using multiple linear regression model,the diagnostic examination frequency in 2016 was estimated to be 826 examinations per 1 000 population,of which the frequency of dianostic X-ray examination and CT examination were 541 per 1 000 and 285 per 1 000,respectively.Conclusions The frequency of diagnostic radiology in Henan has increased rapidly in recent years.All types of diagnostic radiology equipment are unevenly distributed in hospitals at different levels which posed a challenge for health care.Relevant departments should make efforts to reallocation of diagnostic radiology equipment in such hospitals and make utilization of health resources more reasonable.
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Objective To investigate the total examinations of conventional X-ray diagnosis and CT diagnosis of radiation diagnosis and treatment institutions,in order to explore the distribution characteristic of radiological diagnosis frequency and diagnostic patients,and to estimate the application frequency of medical X-ray diagnosis in Heilongjiang province.Methods The questionnaire was sent to all radiation diagnosis and treatment institutions in forms of public document issued by the administrative department of health and family planning of Heilongjiang province.Basic situations and patient numbers of conventional X-ray diagnosis (interventional diagnosis not included) and CT diagnosis in 2016 were collected and summarized combined with sampled on-site verification.The application frequency of medical X-ray diagnosis was obtained using permanent resident population in Heilongjiang province in 2016.Results Totally 1 645 medical radiation institutions were investigated,including 81 tertiary hospitals,359 secondary hospitals,808 primary hospitals or unrated medical institutions,and 397 private dental clinics.The examinations of conventional X-ray diagnosis and CT diagnosis were 7 706 050 and 7 063 734,respectively.The application frequency of conventional X-ray diagnosis and CT diagnosis was 200.9 and 184.1 examinations per 1 000 population,respectively,and varied from 98.0 to 274.7 in different areas.The ratio of examinations in public medical institutions to that in private medical institutions was 7.47 ∶ 1.Conclusions 50％ of the total radiological diagnosis were made in tertiary hospitals,and only 13％ were made in medical institutions below primary in Heilongjiang.Meanwhile,although the number of public and private medical institutions was at the same scale,the total examination of radiological diagnosis in public medical institutions was 7 times of that in private medical institutions.The application frequency of conventional X-ray diagnosis and CT diagnosis in Heilongjiang province in 2016 was similar to that of Jiangsu province in 2015.
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Objective To acquire the basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical radiation of Hebei province in 2016.Methods A survey was made using questionnaires for basic information on medical X-ray diagnosis,interventional radiology,radiotherapy and clinical nuclear medicine.Values of frequencies were derived for each type of medical X-ray procedure by dividing the total population.Results In 2016 there were 2 951 institutions at province level and 6 966 pieces of equipment involved in diagnostic radiology and radiotherapy treatments.Frequency values were estimated to be 379.25 examinations per 1 000 population in medical X-ay diagnosis,2.31 per 1 000 in interventional radiology,0.55 per 1 000 in radiotherapy and 1.65 per 1 000 in clinical nuclear medicine.The frequency for CT examination was 136.39 per 1 000,accounting for 36％ of the total frequencies in the province,with average annual growth rate of 12.4％.The highest value of frequency in clinical nuclear medicine was from Shijiazhuang among all types of medical procedures in different regions,11 times higher than the lowest value found in Hengshui city.Although the number of tertiary hospitals only accounted for 2.3％ of the total number of institutions,they contributed 25.5％,by examination number,of the medical X-ray diagnosis and 35.3％ of the CT examination.Interventional radiology and radiotherapy contributed more than 70％ of the total frequencies in the province,and clinical nuclear medicine was as high as 97.7％.Conclusions The basic information on diagnostic radiology and radiotherapy institutions and the frequency of medical procedures in Hebei in 2016 have been preliminarily made clear.Medical exposure could maintain a long-term growth trend.The frequency distribution of medical procedures in various regions and medical institutions is highly unbalanced.It is desirable to enhance the macroeconomic regulation and the management of medical radiation protection in order to rationally perform all types of diagnostic radiology and radiotherapy treatments to protect the health and safety of the patients and the examined individuals,and to promote the sustainable development of the health care services.
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Objective To study the estimation method of medical exposure frequency in China through the survey of diagnostic radiology and radiotherapy institutions in selected provinces.Methods A survey of medical exposure frequency was carried out involving 557 diagnostic radiology and radiotherapy institutions in 25 provinces.The correlation analysis and multiple linear regression analysis were conducted,with the fitting effects of the models with different variables being compared.Results The total medical exposure frequencies highly correlated with number of outpatient,number of equipment and number of radiation workers (| r| ＞0.5).Representative samples of the daily medical exposure workload were obtained by stratified random sampling from the survey data.Mathematical models were built using the multiple linear regression between total medical exposure frequency and hospital levels,number of outpatients,number of inpatients,number of equipment,and number of radiation workers.The total medical exposure frequency in 2016 was estimated to be 589 million examinations based on the models.In addition,the frequencies of medical procedures were derived using the robust regression and the median regression.Conclusions There are several methods for estimating the total medical exposure frequency.It is desirable to use the stratified random sampling combined with the published statistical and monitoring data.The representativeness of sample is critical.The specification and optimization of models also require further study.
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To ascertain the background and frequency of diagnostic medical X-ray procedures in China and provide the basis for regulatory oversight of such applications,a total of 557 medical institutions in 25 provinces or municipalities were surveyed by means of the optimally designed questionnaires and through stratified quota sampling.The numbers of procedures were calculated in terms of the type of procedures and the sex and age of examined patients.As a result,the frequencies of diagnostic X-ray procedures for 2016 in the country were derived using multiple linear regression analysis.The frequency of X-ray diagnosis in 10 provinces of China in 2016 was estimated to be 379-1 228 examinations per 1 000 population.Diagnostic X-ray applications have shown a rapid expansion in 2016 as compared with the period of "9th Five-Year Plan".It is very important to strengthen the regulation of medical diagnostic X-ray applications.
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Objective@#To analyze the levels of entrance surface dose (ESD) to patients from diagnostic medical X-ray examinations in Inner Mongolia autonomous region.@*Methods@#The investigation of diagnostic medical X-ray examinations was completed in 30% of the number of hospitals under the requirement of the program plan of the national survey on frequency and dose from medical exposure. The investigation of ESDs to patients from general diagnostic X-ray examinations was carried out in terms of the scale of annual outpatients in different levels of hospital. The difference in ESDs to patients was compared for different equipments, different grade hospitals and different exposure sites, with the comparison result being subjected to rank sum test.@*Results@#In all types of diagnostic medical X-ray equipment, DR photography equipment accounted for the majority. During various routine diagnostic X-ray examinations, the average ESDs was lumbar vertebral 3.39 mGy, pelvic and hip 1.65 mGy, cervical spine 0.90 mGy, extremities 0.38 mGy and thorax 0.37 mGy, respectively. In the diagnostic examinations of chest, lumbar and cervical spine, the ESDs caused by the use of screen film photography equipment were higher than those by DR photography equipment, with statistically significant difference (Z=-3.229, -4.820, -5.265, P<0.05).@*Conclusions@#Screen film photography equipment results in higher ESD than DR photography equipment. The doctor′s operation behavior is an important factor that affects the ESD.