摘要目的:探讨多层级质量控制体系在健康管理中心的应用效果。方法:2019年8月在汉中市中心医院健康管理中心首次构建“院-科-组”“科-组-质控员”多层级质量控制体系。选取2018年8月—2020年7月在汉中市中心医院健康管理中心进行健康体检的全体体检者83 619例为研究对象，其中2018年8月—2019年7月体检者32 009例为对照组，2019年8月—2020年7月体检者51 610例为试验组，分别观察两组重要异常结果及时通知情况和“四高”（高血压、高血糖、高血脂、高尿酸）人群随访情况。选取对照组和试验组中连续两年均在汉中市中心医院健康管理中心体检且体检项目基本一致的某固定单位人员满意度调查表各2 000份、体检报告各2 000份（报告检查组为同一组人员，前后标准一致），分别统计两组体检者满意率情况、体检报告合格情况。结果:试验组重要异常结果及时通知率（99.4%比96.6%）、“四高”人群随访率（高血压95.1%比91.2%、高血糖95.3%比91.6%、高血脂94.6%比92.3%、高尿酸92.7%比86.4%）、体检者满意率（体检环境94.0%比91.3%、服务态度96.4%比91.9%、等候时间97.6%比95.4%、体检流程98.3%比96.8%、医务人员专业水平97.2%比95.1%）、体检报告合格率（录入信息准确性99.5%比98.1%、主检结论准确性99.4%比97.3%、排序规范性99.8%比98.8%、健康建议合理性99.2%比96.8%）均显著高于对照组（均 P<0.05）。 结论:建立多层级健康体检质量控制体系，可提高体检重要异常结果及时通知率、“四高”人群随访率、体检者满意率和体检报告合格率。

abstractsObjective:To explore the application and effect of multi-level quality control system (referred to as “quality control”) in health management center setting.Methods:The health management center of Hanzhong Central Hospital constructed a multi-level quality control system of “hospital-department-unit” and “department-unit-quality-controller” in August 2019. A total of 83 619 people who underwent physical examination in the Health Management Center of Hanzhong Central Hospital from August 2018 to July 2020 were selected as the subjects. 32 009 people who underwent physical examination from August 2018 to July 2019 were selected as the control group, and 51 610 people who underwent physical examination from August 2019 to July 2020 were selected as the experimental group. The timely notification of important abnormal results and the follow-up of the “four-high” population (hypertension, hyperglycemia, hyperlipidemia, and hyperuricemia) were observed. Two thousand satisfaction questionnaires and two thousand physical examination reports were collected from the institutions who had received both physical examination in the Health Management Center of Hanzhong Central Hospital for two consecutive years. The physical examination items of the above clients were basically the same. The satisfaction rate of the two groups of physical examination and the qualification rate of the physical examination reports were measured respectively.Results:The results showed that the timely notification rate of important abnormal results (99.4% vs 96.6%), follow-up rate of “four-high” population (hypertension 95.1% vs 91.2%, hyperglycemia 95.3% vs 91.6%, hyperlipidemia 94.6% vs 92.3%, hyperuricemia 92.7% vs 86.4%), satisfaction rate of physical examination (physical examination environment 94.0% vs 91.3%, service attitude 96.4% vs 91.9%, waiting time 97.6% vs 95.4%, physical examination process 98.3% vs 96.8%, professional level of medical staff 97.2% vs 95.1%), and qualified rate of physical examination report (accuracy of input information 99.5% vs 98.1%, accuracy of main examination conclusion 99.4% vs 97.3%, normative sorting 99.8% vs 98.8%, rationality of health advice 99.2% vs 96.8%) in the experimental group were significantly higher than those in the control group (all P<0.05). Conclusion:The establishment of a multi-level quality control system in health examination service can improve the timely notification rate of important abnormal results, the follow-up rate of the “four-high” population, the satisfaction of physical examinees, and the qualified rate of physical examination reports.