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The Status Of Clinical Diagnostic Imaging Services In Uganda’s Regional Referral Hospitals In 2007

机译：2007年乌干达地区转诊医院的临床诊断影像服务现状

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Background: Clinical imaging is an essential component of health care which supports and improves the effectiveness of clinical decision-making. Quality care saves lives and resources of both the patient and the health system. However, many developing countries have neglected diagnostics, especially clinical imaging. Non-use of or poor imaging services lead to wrong diagnosis and treatment, unnecessary health expenditures, and poor health outcomes. Regional Referral Hospitals should have good diagnostic imaging services to provide expert care and bridge the continuum of care by stemming the flow of uncomplicated cases from general hospitals to National Referral Hospitals.Aim: To determine the situation of diagnostic imaging services at regional referral hospitals in Uganda.Methods: A descriptive cross-sectional survey of all the nine Regional Referral Hospitals of Uganda was done in 2007. Environmental inspection of the imaging units, process observation and exit interviews with 156 patients present on the day of the visit were done to assess their satisfaction with the imaging services. Staff were also interviewed. However, quality validation of the imaging outputs was not done. Selected health facilities in the capital Kampala were visited to obtain data on patients referred from upcountry. Five-year hospital records were reviewed for outputs.Results: The premises were of poor quality and staff and patients were not safe from radiation exposure. No radiosurveillance measures were operational. The output of imaging services was generally very low, (mean: 16 procedures per day, range: 6 - 22) due to lack of consumable inputs. Only 37% (range: 14 – 64) of approved staff positions were filled. Nurses were insufficient and some cadres lacked altogether. Stock-outs of key consumable inputs were prolonged (ultrasound gel: 90 days) and patients were required to buy their own. Many patients were referred to private services but not recorded. Central level supervision by the Ministry of Health was lacking.Conclusion and recommendation: The quality of imaging services was poor, and could be improved through higher prioritization of imaging services in hospital planning, better financing, better support supervision and establishment of an active radiosurveillance mechanism.
机译：背景：临床成像是医疗保健的重要组成部分，可支持并提高临床决策的有效性。优质的护理可以挽救患者和医疗系统的生命和资源。但是，许多发展中国家忽视了诊断，尤其是临床影像学。不使用或成像服务不佳会导致错误的诊断和治疗，不必要的健康支出以及不良的健康结果。区域转诊医院应提供良好的诊断影像服务，以阻止专家从普通医院到国家转诊医院的流转，从而提供专家护理并架设连续的医疗服务。目的：确定乌干达区域转诊医院的影像诊断服务的情况方法：2007年对乌干达的所有九家地区转诊医院进行了描述性横断面调查。在就诊当天对成像单元进行了环境检查，对过程中的观察和156名患者进行了出访采访，以评估他们的状况对影像服务感到满意。工作人员也接受了采访。但是，没有对成像输出进行质量验证。访问了首都坎帕拉的部分医疗机构，以获取有关从内陆转诊的患者的数据。结果回顾了五年医院的记录。结果：场所质量差，员工和患者不安全。没有采取任何放射监视措施。由于缺乏耗材，成像服务的输出通常非常低（平均：每天16个程序，范围：6-22）。只有37％（14 – 64）的批准人员职位被填补。护士不足，一些干部完全缺乏。关键消耗品的缺货时间延长（超声凝胶：90天），患者需要自己购买。许多患者被转介到私人服务机构，但没有记录。缺乏卫生部的中央监督。结论和建议：影像服务质量差，可以通过在医院规划中优先考虑影像服务，改善融资，更好地支持监督以及建立积极的放射监视机制来提高影像服务的质量。 。

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