摘要
目的评价医疗卫生机构为HIV/AIDS患者提供转介服务的效果,为建立一个有效的艾滋病转介服务体系提供科学依据。方法从艾滋病综合防治数据信息系统中,获得HIV/AIDS患者的CD4检测率、抗病毒治疗覆盖率、单阳家庭配偶HIV抗体检测率;通过15个县、区上报的转介报表,收集转介情况,追踪转介人群到位治疗情况;通过对建立艾滋病转介服务体系前后防治艾滋病的各项考核指标和HIV/AIDS患者的有效转介情况进行比较分析,评估转介服务模式的效果。结果建立转介服务体系后,在当年新发现报告病例中,转介率由76.89%提高到99.48%(χ^2=462.757,P<0.001);成功转介治疗率由57.02%提高到82.42%(χ^2=244.632,P<0.001);CD4检测率由61.46%提高到98.70%(χ^2=813.233,P<0.001);当年接受抗病毒治疗比例由56.04%提高到83.35%(χ^2=290.756,P<0.001),差异均有统计学意义。当年发现报告并已抗病毒治疗病例确证距治疗平均天数由(26.37±12.64)天缩短为(17.11±6.37)天,差异有统计学意义(U=20.74,P<0.001)。在累计报告当年存活未治疗的病例中,转介率由26.09%提高到59.48%(χ^2=370.243,P<0.001);成功转介治疗率由17.01%提高到52.42%(χ^2=137.647,P<0.001);CD4检测率由37.49%提高到51.73%(χ^2=67.444,P<0.001),差异均有统计学意义。在当年存活可随访的病例中,CD4检测率由77.56%提高到87.21%(χ^2=331.498,P<0.001);抗病毒治疗覆盖率由77.08%提高到83.54%(χ^2=226.009,P<0.001);HIV/AIDS患者的配偶或固定性伴HIV检测率由76.29%提高到90.49%(χ^2=179.660,P<0.001),差异均有统计学意义。结论广西南宁市HIV/AIDS患者转介服务模式是有效的。今后进一步加强存活未治疗病例的管理和提高医疗机构结果告知服务质量,以确保HIV/AIDS患者的有效管理和治疗,防止HIV的二代传播。
Objective To evaluate the effectiveness of referral services for HIV-infected individuals and AIDS patients(i.e. HIV/AIDS) in medical and health institutions, and to provide a scientific basis for establishing an effective HIV referral service system. Methods The CD4 detection rate, antiviral treatment coverage rate and HIV antibody detection rate of single positive family spouses of HIV/AIDS patients were obtained from the AIDS comprehensive prevention and treatment data information system. Through the referral reports submitted by 15 counties and districts, the referral status was collected and the therapy status of referral group was followed up. We evaluated the effectiveness of the referral service model by comparing and analyzing the indicators for AIDS prevention before and after the establishment of the AIDS referral service system and the effective referral of HIV/AIDS patients. Results After establishing the referral service system, the referral rate increased from 76.89% to 99.48% in the newly reported cases in the same year(χ^2=462.757, P<0.001), the successful referral treatment rate from 57.02% to 82.42%(χ^2=244.632, P<0.001), the CD4 detection rate from 61.46% to 98.70%(χ^2=813.233, P<0.001), and the proportion of receiving antiretroviral treatment from 56.04% to 83.35%(χ^2=290.756, P<0.001) in the same year, showing statistically significant differences. The average number of days between detection and confirmation of reported antiviral treatment cases decreased from(26.37±12.64) days to(17.11±6.37) days, with a statistically significant difference(U=20.74, P<0.001). In the cumulatively reported surviving but untreated cases in the same year, the referral rate increased from 26.09% to 59.48%(χ^2=370.243, P<0.001), the successful referral treatment rate from 17.01% to 52.42%(χ^2=137.647, P<0.001), and the CD4 detection rate from 37.49% to 51.73%(χ^2= 67.444,P<0.001),showing statistically significant differences. In the surviving and follow-up cases in the same year,the CD4 detection rate i
作者
农丽萍
何波
汤洪洋
岑平
林倩
李斯斯
徐红
姚敏
覃威翱
邓小芳
NONG Li-ping;HE Bo;TANG Hong-yang;CEN Ping;LIN Qian;LI Si-si;XU Hong;YAO Min;QIN Wei-ao;DENG Xiao-fang(Nanning Municipal Center for Disease Control and Prevention,Nanning,Guangxi 530023,China)
出处
《实用预防医学》
CAS
2019年第8期919-923,共5页
Practical Preventive Medicine
基金
广西卫生和计划生育委员会科研课题(Z20181042,Z20180347)
关键词
艾滋病
HIV/AIDS病例
转介服务
效果评价
acquired immunodeficiency syndrome
HIV/AIDS case
referral service
effect evaluation
