摘要
目的在试点地区实施以加强病人报告、转诊以及追踪为重点的提高病人发现的综合措施,并对其可行性、可操作性及对病人发现的影响进行评价和评估。方法在3个省选择DOTS实施质量较好的13个县(区)进行前瞻性研究。通过加强结防机构与医院的合作来实施以加强病人报告、转诊以及追踪为重点的提高病人发现的综合措施,共计6个月。收集试点前同期以及试点期间有关的定性及定量信息,并予以比较、分析。结果与试点前同期相比,开展试点之后试点地区建立并完善了结防机构与医院的合作机制,肺结核病人报告、转诊、追踪程序得以规范和完善。从对37家目标医院前后病人登记、报告、转诊及到位情况的比较来看,无论是登记、报告、转诊的病人数,还是报告率、转诊率、到位率,试点期间均明显高于试点前同期水平。网络直报系统报告的应转诊病人的总体到位率为82.6%。结防机构登记的来源于医院的涂阳结核病人发现明显增加,试点期间6个月的病人数是试点前同期的1.4倍。结论试点地区开展的以加强病人报告、转诊以及追踪为重点的提高病人发现的综合措施是可行的;试点地区所获得的有关经验值得其他地区借鉴。
Objective To test the feasibility of the interventions on reporting,referring and tracing of tuberculosis patients and to determine the impact of the interventions on case finding in a pilot area.Methods Perspective study was carried out in the counties(districts) with acceptable DOTS implementation quality in three provinces.A package of interventions focused on improving reporting,referring and tracing tuberculosis patients through the cooperation between hospitals and tuberculosis dispensaries were implemented in the pilot area for 6 months.The qualitative and quantitative data collected from the same period of previous year of the pilot and from the duration of the pilot were compared and analyzed.Results Compared with the previous year of the pilot,the mechanism of cooperation between hospitals and tuberculosis dispensaries has been established and improved,and the standardized working procedures on reporting,referring within hospitals and tracing from tuberculosis dispensaries has been implemented and improved.The data from target hospitals showed that not only the absolute number of identified patients,reported patients,and referred patients but also the percentage of reported patients,referred patients increased significantly comparing with the data before the pilot.The overall arrival rate of the reported patients from the Internet Based Communicable Diseases Reporting System that should be referred was 82.6%.The overall impact result showed that among registered tuberculosis patients in tuberculosis dispensaries,the number of confirmed TB patients from all hospitals increased 1.4 times.This contributed to the overall patients finding in the pilot area.Conclusion The package of approaches to strengthen the cooperation between hospitals and tuberculosis dispensaries focused on improving reporting,referring and tracing are feasible.Case finding increased significantly through the related interventions.The experiences and some key parameters could be applied in the planning process of PPM-DOTS expansion.
出处
《中国防痨杂志》
CAS
2007年第6期479-483,共5页
Chinese Journal of Antituberculosis
关键词
结核
肺/预防和控制
预防卫生服务
Pulmonary tuberculosis/prevention and control
Preventive health services
