摘要
目的探讨医疗单位向结防机构转诊的结核病人归口管理方法,提高病人发现率,规范病人治疗管理。方法结合湖南省实际,制订切实可行的结核病人归口管理实施办法与措施;对邵阳、常德和怀化3市实施《湖南省结核病人归口管理工作规范》(简称《规范》)前后,结核病人归口管理实施结果进行对照分析。结果实施《规范》前3市共接诊初诊病人29 953例,实施《规范》后为51 468例,后者较前者增长了71.8%。在初诊病人中,直接到结核病防治机构就诊者增加13 056例,增长了51.0%,医疗单位转诊者增加21 515例,增长194.0%。实施《规范》前,3市共发现新涂阳病人5 201例,实施《规范》后为10 596例,前后比较增长了103.7%。在新涂阳病人中,直接到结防机构就诊者较实施《规范》前增加1 944例,增长了47.3%,医疗单位转诊者增加3 451例,增长315.2%。在转诊病人中,县级医疗单位和乡级医疗单位比实施《规范》前分别增加1 932和1 385例,分别增长了337.8%和324.4%。同期全省实施《规范》地区和未实施《规范》地区新涂阳病人登记率分别58.47/10万和30.13/10万,前者比后者高94.4%。结论《湖南省结核病人归口管理工作规范》的实施方法与措施是可行的结核病人归口管理办法;做好结核病归口管理是提高病人发现率的有效方法。
Objective To explore the management methods of referring TB cases and suspects from general ospital to TB dispensary. Methods An operational research was conducted in 3 cities with 38 jurisdiction counties in Hunan province. Compare the case-finding level and the source of TB case and suspect before and after the implementation of the referral system during the study period. Results After the implementation of the referral system, the number of initial consultation cases were 51 468, increased by 71.8% compared with the level of 29 953 before the implementation of the referral system in the 3 prefectures. Among the initial consultation cases, 13 056 arrived TB dispensary directly, increased by 51.0% and the number of cases referred by general hospital increased 21 515 （194.0%）. The registered new smear positive pulmonary TB cases increase by 103.7% with absolute number from 5 201 to 10 956. Among the new smear positive cases, the number of cases arrived TB dispensary directly increased by 1 944 （47.3%） and the number of cases referred by general hospital increased by 3 451 （315.2%）. The number of cases referred by county hospital and township hospital increased by 1 932（337.8%） and 1 385 （324.4%） respectively The notification of new smearpositive pulmonary TB was 58.47/100 000 in the project area and 30.13/100 000 in the non-project area in the same duration. The notification in project area was 94.4% higher than it was in non-project area. Conclusion In order to improve the case-finding level of pulmonary TB, the referring system implementation is a feasible and effective strategy.
出处
《中国防痨杂志》
CAS
2006年第5期269-273,共5页
Chinese Journal of Antituberculosis
关键词
结核
肺/预防和控制
Pulmonary tuberculosis/prevention and control
