1993～2010年中国城乡结核病患者卫生服务利用趋势分析  

Analyzing the trend of health services utilization of patients with tuberculosis in rural and urban China from 1993 to 2010

作　　者：吴静[1] 饶克勤[2] 钱军程[3] 蔡敏[3] 阮云洲[4] 刘远立[5] 

机构地区：[1]中国疾病预防控制中心慢病社区处,北京102206 [2]中华医学会 [3]卫生部统计信息中心 [4]中国疾病预防控制中心结核病预防控制中心 [5]美国哈佛大学

出　　处：《中国卫生事业管理》2013年第8期637-639,共3页Chinese Health Service Management

基　　金：世界银行贷款卫十项目课题

摘　　要：目的:分析1993～2010年间中国城乡地区结核病患者的卫生服务利用情况及其变化趋势。方法:利用1993、1998、2003和2008年全国卫生服务家庭调查数据,结合2000年和2010年全国结核病流行病学调查数据,计算中国1993-2010年间城市和农村地区结核病患者的主动就诊、未治疗、门诊及住院比例。结果:结核患病率从1993年到2003年呈下降趋势,但到2008年无论城乡均有所上升。有结核症状者的主动就诊率2000年在城市和农村地区分别为65.1%和56.0%,到2010年下降为47.3%和46.6%。已被确诊的结核病患者中,未采取任何治疗措施的患者比例从1993年到2003年有所下降,但到2008年又略有上升,在城市和农村分别为12.6%和9.7%。不同年份的结核病患者门诊就诊率和住院率不同,但城乡之间无显著性差异。结论 1993至2010年间,结核病防控依然重要,但无论在城市还是农村地区,卫生服务利用仍然不足,特别是主动就诊率还在下降,给防控工作带来严峻挑战。因此必须从患者和卫生机构两个方面采取措施,重点加强早期发现和规范治疗管理两个薄弱环节。Objective To analyze the status and trend of health services utilization of patients with tuberculosis in rural and urban China from 1993 to 2010. Methods Data from National Health Service Survey in 1993,1998,2003 and 2008 ,and data of na- tional epidemiological survey of TB in 2000 and 2010 were used to calculate indexes for patients with tuberculosis in rural and ur- ban China from 1993 to 2010,including the rate of seeing a doctor,forgone treatment, outpatient services and inpatient services. Results The prevalence rate of TB decreased from 1993 to 2003 ,while it increased in 2008. The rate of seeing a doctor for suspect TB patients was 65.1% in urban areas and 56.0% in rural areas respectively in 2000 ,which decreased to 47.3% and 46.6% respectively in 2010. The rate of forgone treatment among TB patients had decreased from 1993 to 2003, while increased in 2008, which was 12.6% in urban area and 9.7% in rural area respectively. There had different outpatient services rate and inpatient services rate in different years,which had no significant differences between urban and rural areas. Conclusion Utilization of health services was insufficient in rural and urban China, which had made great challenge on TB control and prevention. It was suggested to take measures.from both patients and health institutions ,especially to strengthen determination in early-stage and management on regular treatment for TB patients.

关 键 词：结核病 卫生服务利用 城乡 时间趋势 

分 类 号：R197.1[医药卫生—卫生事业管理]