家庭医生签约服务与肺结核患者临床特征的关联性研究  

A study on the correlation between family doctor contract services and clinical characteristics of pulmonary tuberculosis patients

作　　者：蔡晓婷[1] 伍小英[1] 何立乾[1] 江坤洪[1] Cai Xiaoting;Wu Xiaoying;He Liqian;Jiang Kunhong(Department of Governance,the Second Division of Institute,Guangzhou Chest Hospital(Guangzhou Tuberculosis Control Institute),Guangzhou 510095,China)

机构地区：[1]广州市胸科医院(广州市结核病防治所)二分所管治科,广州510095

出　　处：《结核与肺部疾病杂志》2024年第4期333-338,共6页Journal of Tuberculosis and Lung Disease

基　　金：广州市科技计划项目(2024A03J0588)。

摘　　要：目的:通过比较已签约家庭医生和未签约家庭医生的肺结核患者临床特征的相关数据,为社区结核病管理模式提供依据。方法:选取2022年1月至2023年12月在“结核病管理信息系统”中住址登记为广州市海珠区的肺结核患者作为研究对象,共1479例。其中,已签约并接受家庭医生服务者为管理组(844例,57.06%),未签约家庭医生服务者为对照组(635例,42.94%)。收集并比较两组研究对象的人口学特征和临床特征信息。结果:管理组平均年龄为(48.48±18.38)岁,明显低于对照组的平均年龄[(50.73±18.91)岁],差异有统计学意义(t=-2.303,P=0.021)。管理组流动人口、病灶范围≥3个肺野、有空洞、合并糖尿病、合并高尿酸血症者分别占54.27%(458/844)、58.65%(495/844)、32.11%(271/844)、12.56%(106/844)、8.18%(69/844),均明显高于对照组[分别占48.50%(308/635)、48.50%(308/635)、26.93%(171/635)、8.98%(57/635)、3.78%(24/635)],差异均有统计学意义(χ^(2)值分别为9.638、15.030、4.640、4.744、11.883,P值均<0.05)。管理组合并高血压、合并肿瘤、发生药物不良反应及首诊住院治疗者分别占6.40%(54/844)、3.32%(28/844)、10.90%(92/844)、27.49%(232/844),均明显低于对照组[分别为10.71%(68/635)、5.51%(35/635)、15.12%(96/635)、36.22%(230/635)],差异均有统计学意义(χ^(2)值分别为8.896、4.278、5.809、12.864,P值均<0.05)。结论:家庭医生签约服务与肺结核患者的临床特征之间存在着明显的关联性,这为进一步改善肺结核患者的医疗管理提供了重要的参考和指导。Objective:This study aimed to provides evidence for community tuberculosis management models by comparing relevant data on clinical characteristics of pulmonary tuberculosis patients who had signed up for family doctors with those who had not.Methods:A total of 1479 cases of pulmonary tuberculosis patients registered in the“Tuberculosis Management Information System”from January 2022 to December 2023 in Haizhu District of Guangzhou were selected as the study subjects.Among them,the management group consisted of 844 cases(57.06%)who had signed up and received family doctor services,while the control group consisted of 635 cases(42.94%)who had not signed up for family doctor services.The demographic and clinical characteristics information of the two groups were collected and compared.Results:The average age of the management group was(48.48±18.38)years,which was significantly lower than that of the control group((50.73±18.91)years,t=-2.303,P=0.021).The floating population,the focus range≥3 lung fields,cavities,diabetes,and hyperuricemia in the management group accounted for 54.27%(458/844),58.65%(495/844),32.11%(271/844),12.56%(106/844),and 8.18%(69/844),which were significantly higher than those in the control group(48.50%(308/635),48.50%(308/634),26.93%(171/635),8.98%(57/635),and 3.78%(24/635);χ^(2) values were 9.638,15.030,4.640,4.744 and 11.883,respectively;all Ps<0.05).The proportions of patients with hypertension,concomitant tumors,adverse drug reactions,and initial hospitalization in the management group were 6.40%(54/844),3.32%(28/844),10.90%(92/844),and 27.49%(232/844),respectively,which were significantly lower than those in the control group(10.71%(68/635),5.51%(35/635),15.12%(96/635),and 36.22%(230/635),respectively;χ^(2) values were 8.896,4.278,5.809,and 12.864,respectively;all Ps<0.05).Conclusion:There is a significant correlation between family doctor contract services and the clinical characteristics of tuberculosis patients,which provides important reference and guidance for further impr

关 键 词：结核 肺 家庭医疗保健服务 基于医院的 病例管理 疾病特征 

分 类 号：R521[医药卫生—内科学]