张掖市结核病防治服务体系转型前后病人发现分析  

Analysis of patient discovery before and after transition of service system for tuberculosis prevention and control in Zhangye

作　　者：徐兴祥[1] 卢莉萍[1] 张军[1] 袁伟鹏[1] 邵芙蓉[1] 张婷婷[1] 

机构地区：[1]甘肃省张掖市疾病预防控制中心,甘肃张掖734000

出　　处：《疾病预防控制通报》2018年第1期43-45,共3页Bulletin of Disease Control & Prevention(China)

摘　　要：目的分析比较甘肃省张掖市结核病防治服务体系转型前后结核病病人发现情况,为更好地实施新型结核病防治服务体系提供参考。方法收集2015年(结核病服务体系转型前)和2016年(结核病服务体系转型后)病人发现相关资料,统计分析数据。结果结核病防治服务体系转型前后,初诊就诊率分别为338.86/10万和318.25/10万,差异具有统计学意义(χ~2=7.95,P<0.01);活动性肺结核病病人登记率分别为97.60/10万和100.30/10万,新涂阳肺结核病病人登记率分别为14.63/10万和11.40/10万,较转型前均有下降,转型前后活动性肺结核病病人登记率差异无统计学意义(χ~2=0.48,P>0.01),新涂阳肺结核病病人登记率差异具有统计学意义(χ~2=7.04,P<0.01);肺结核病病人主要来源为转诊,分别占55.83%和70.51%,较转型前明显提高,差异具有统计学意义(χ~2=57.01,P<0.01)。结论结核病防治服务体系转型后,初诊就诊率、新涂阳肺结核病病人登记率较转型前均有所下降,转诊构成比明显提高,转型后防治工作质量有所下降;建议加大结核病防治知识宣传力度,加快定点医院结核病诊治门诊报销制度的落实和结核病接诊医生的培训力度,加强定点医疗机构专科能力建设,疾病预防控制机构和基层医疗机构加强对病人的追踪及管理。objective To compare and analyze patient discovery situation before and after the transition of the service system for tuberculosis（TB） prevention and control in Zhangye city, Gansu province and provide reference for implementation of the new TB services system. Methods Information of TB patients in 2015（before the transition of the service system for TB prevention and control） and 2016（after the transition） were collected and analyzed statistically. Results Before and after the transition of the service system for TB prevention and control, the rate of initial visit was 338.86/100 000 and 318.25/100 000 respectively with statistical difference（χ~2=7.95, P0.01）; the registration rate of active pulmonary TB patients was 97.60/100 000 and 100.30/100 000 respectively without statistical difference（χ~2=0.48, P0.01）, and the registration rate of new TB patient with smear positive was 14.63/100 000 and 11.40/100 000 respectively with statistical difference（χ~2=7.04, P0.01）. The pulmonary TB patients were mainly from referral before（55.83%） and after（70.51%） the transition with statistical difference（χ~2=57.01, P0.01）. Conclusions After the transition of the service system for TB prevention and control, both initial visit rate and the registration rate of new pulmonary TB patients with smear positive decreased, but the proportion of referral increased obviously and the quality of prevention and control declined. It is suggested to enhance publicity of TB prevention and control and the clinician training, accelerate the implementation of reimbursement for expenses of TB diagnosis and treatment in designated hospital, reinforce the capacity building of TB department in the designated medical organization and strengthen patient tracking and management.

关 键 词：结核病 防治服务新体系 病人发现 

分 类 号：R52[医药卫生—内科学]