通过建立激励机制提高肺结核患者发现和治疗效果的研究  

Study on improving tuberculosis case detection and treatment through establishing incentive mechanism

作　　者：胡冬梅[1] 何广学[1] 刘剑君[2] 范月玲[3] 

机构地区：[1]中国疾病预防控制中心结核病预防控制中心,北京100050 [2]中国疾病预防控制中心,北京100050 [3]山西省疾病预防控制中心,山西太原030012

出　　处：《中国健康教育》2008年第6期436-438,共3页Chinese Journal of Health Education

基　　金：国际防痨与肺病联合会FIDELIS结核病控制项目(No2004-fid-4-034)

摘　　要：目的探讨激励机制对提高肺结核患者发现和治疗效果的作用,为制定结核病控制策略提供科学依据。方法FIDELIS项目于2004年11月至2005年10月在山西省50个县实施,主要措施是向贫困患者和卫生服务人员提供激励机制。结果项目地区新涂阳患者登记数在项目实施前为5105例,项目实施后为7736例,项目实施后患者数是项目前的151.5%(P<0.01)。项目实施前后,治疗2个月末痰菌阴转率分别为95.5%和96.0%,患者治愈率分别为93.4%和95.2%。结论在山西省的50个县采取的激励机制是十分有效的,符合投入-效益原则。Objective To establish incentive mechanism for improving TB case detection while maintain high cure rate, and to provide evidence for making TB control policy. Methods The FIDELIS project was implemented from Nov. 2004 to Oct. 2005 in 50 counties of Shanxi Province, with the main intervention of providing incentive mechanism to poor TB patients and health service providers. Results The number of new smear positive TB cases significantly increased from 5105 to 7736 （P〈0.01）. The sputum conversion rate before and after treatment were 95.5% and 96.0% respectively. The cure rate were 93.4% and 95.2%. Conclusion The incentive mechanism established in Shanxi FIDELIS project included providing transportation fee to poor patients upon their visit to TB dispensary for TB diagnosis, providing incentive for doctors who referred a new smear positive patient to TB dispensary, for village doctors on directly observing the six month treatment of a new smear positive patient. The results indicated the incentive mechanism was effective and cost-benefit.

关 键 词：结核病 激励机制 FIDELIS 

分 类 号：R193[医药卫生—卫生事业管理] R521[医药卫生—公共卫生与预防医学]