Abstract
Objective: To explore quality of spirometry in Hunan province and the impact of education on it. Methods: Cross-sectional study and a prospective randomized cohort study. (1) A total of 460 public hospitals in Hunan province were investigated. Research assistants collected 20 consecutive reports of pulmonary ventilation test reports (PVTRs) and basal information of those hospitals which owned spirometry. (2) To measure the effect of education, 28 randomly selected 2(nd) level hospitals which owned spirometry were randomized to intervention and control group (1∶1). The intervention group received a short-time training which included face-to-face lectures and a hand-by-hand operation training course, while the control group received usual care. PVTRs were investigated 3 months after the intervention. All PVTRs were classified to grade A, B, C, D and E according to the Chinese pulmonary ventilation test (PVT) guidelines. Results: The recovery rate was 100%. The spirometry-equipped ratio was 1.6% (2/129) at 1(st) level hospitals, 39.0% (105/269) at 2(nd) level hospitals, 100% (62/62) at 3(rd) level hospitals in Hunan province. There were 100% (2/2), 91.4% (96/105) and 93.5% (58/62) utilization rate at 1(st), 2(nd) and 3(rd) level hospitals. Common reasons for not owning a spirometer were equipment cost and insufficient insurance. Lack of knowledge about spirometry and inadequate benefits were the top two reasons for low utilization rate. There were 3 120 PVTRs from 156 hospitals which used spirometry, a total of 50.4% (1 574/3 120) PVTRs got grade A, a total of 14.8% (462/3 120) PVTRs were judged as unreliable (grade D, E). There were 560 PVTRs and 28 questionnaires, respectively, before and after intervention. The technicians' knowledge improved after education compared to before (9.8±0.6 vs 8.6±1.1) (P<0.05). And 75.0% (210/280) PVTRs got A grade in the intervention group, which was significantly higher than those in the control group (75.0% vs 37.9%, P<0.05). While none of PVTRs was unreliable, which was lower than that in the control group (0 vs 14.6%, P<0.05). Conclusions: The equipment ratio and the utilization rate of spirometry are still low and imbalanced among three levels hospitals in Hunan. The short-time training is helpful to improve quality of spirometry.
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