网络直报系统和激励机制提高肺结核病患者发现率  

Increasing Tuberculosis Case Finding Rate by Internet-Based Surveillance System and Encouragement Mechanism

作　　者：吴建林[1] 曹慧[1] 王召伟[1] 刘刚[1] 饶正远[1] 陈秋[1] 刘勇[1] 王梅引[1] 何金戈[1] 夏勇[1] 孙唯[1] 唐兴华[1] 刘杨椅[1] 熊国屏[1] 

机构地区：[1]四川省疾病预防控制中心,四川成都610041

出　　处：《预防医学情报杂志》2007年第3期259-261,共3页Journal of Preventive Medicine Information

基　　金：国际防痨与肺部疾病联合会(IUATLD)FIDELIS项目基金

摘　　要：目的探索在贫穷和边远地区提高肺结核病患者发现率的方式。方法在项目县利用传染病网络直报系统提供的信息,建立激励机制,改善卫生服务形式,加强患者追踪,以提高非结防机构报告患者的复查率和发现率。结果项目县非结防机构报告的患者落实追踪率、到位率、查痰率和涂阳检出率分别为93.1%、60.2%、87.1%和50.3%,高于全省同期水平;新发涂阳肺结核病患者发现率项目县比非项目县多增加42.7%;县级痰涂片检查质量优于乡级痰检点。结论通过有效的激励机制吸纳更多的基层卫生服务提供者参与结核病控制,改进公共卫生服务的公平性和可及性,采取医务人员与患者面对面形式,由乡村医生主动收集痰标本涂片送检,是提高贫穷和边远地区肺结核病患者发现率的有效方式。Objective To explore the methods of increasing tuberculosis case finding rate in poverty and jumping-off areas. Methods 50 poverty counties in Sichuan with 38.68 million population and smear positive rate below 20/105 in 2003 were selected as project counties.Information provided by the infectious disease internet-based surveillance system was made use of. Encouragement mechanism was built up, the health service form was improved and the case tracing was strengthened. Results In the project counties, the tracing rate, arriving rate and smear-sputum rate and smear positive rate of cases reported by non-TB organizations were 93.1%, 60.2%, 87.1% and 50.3%, which were higher than the average levels in the whole province synchronously.The finding rate of new smear positive cases in project counties increased 42.7% compared with non-project counties. The smear-sputum detection qualtity in counties was better than that in townships. Conclusion Building up encouragement mechanism to effectively absorb more public health service supplier in basic level to participate in the tuberculosis control, improving the equity and accessibility of the public health service, adopting the face-to-face service form, and collecting and sending sputum specimen actively by country doctors are valid ways to raise finding rate of tuberculosis cases in poverty and jumping-off areas.

关 键 词：网络直报 激励机制 肺结核 患者发现 

分 类 号：R521.6[医药卫生—内科学]