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目的调查分析转入地结防机构反馈“未到位”的流动人口肺结核患者的去向和原因,采用针对性措施实施干预并进行效果评价,为结防机构更好地开展跨区域管理工作提供借鉴。方法分别电话调查被转入地结防机构反馈“未到位”的流动人口肺结核患者及其转入地结防机构该患者的到位情况和未到位原因,采取增加资料采集、加强宣教、纠正医院到位患者的反馈信息、定时双向核实到位情况和经济激励的针对性措施干预4年。使用SPSS 17.0软件,对调查研究的结果采用描述性统计方法分析,对类实验采用χ~2检验方法分析并计算RR值及其95%的置信区间。结果电话调查患者结果显示,无法联系者为43.28%(29/67),到独立的结核病定点医疗机构就诊者为22.39%(15/67),已到位转入地结防机构就诊者为17.91%(12/67),未就诊者为16.42%(11/67)。对转入地结防机构电话调查结果显示,未到位患者为70.15%(47/67),到位患者为29.85%(20/67)。除无法联系的患者外,其他患者均与转入地结防机构调查结果一致(56.72%,38/67)。转入地结防机构误反馈“未到位”率为29.85%(20/67),原因主要为反馈人员未获得患者门诊到位信息(45.00%,9/20)、患者到位后原“未到位”反馈结果忘记更改(20.00%,4/20)、因专报系统故障导致“未到位”的反馈结果无法更改(10.00%,2/20)和经费不足(10.00%,2/20)。类实验中,干预组到位率为82.62%(233/282),明显高于对照组的62.47%(112/179),二者差异有统计学意义(χ~2=23.39,P<0.001)。结论患者被反馈“未到位”原因主要为缺乏宣教、到独立的定点医疗机构就诊、转入地责任心不足,针对性干预措施有效且可行。
Objective To investigate and analyze the causes and causes of tuberculosis patients who migrate to the place where the prevention and control institutions feedback, “not yet in place”, using targeted measures to implement interventions and evaluate the effects, so as to provide more opportunities for the establishment of antisubmarine prevention agencies to carry out trans-regional management Learn from Methods The telephone survey was transferred to the local anti-TB agency feedback “not in place ” of floating population of TB patients and their transfer to the prevention and treatment institutions in place of the patient and the reasons for not in place, to increase data collection, to strengthen education, to correct Hospital patient feedback information in place, regular two-way verification of the situation and the economic incentives targeted intervention 4 years. Using SPSS 17.0 software, the results of the survey were analyzed using descriptive statistical methods. The χ ~ 2 test was used to analyze and calculate the RR value and its 95% confidence interval. Results The phone survey showed that 43.28% (29/67) of the patients could not be contacted, 22.39% (15/67) of the patients visited the independent TB medical institutions, and 17.91% (12/67) and 16.42% (11/67) of non-attendants. Results of telephone survey conducted by the prevention and treatment agencies in the places where the patients were admitted showed that 70.15% (47/67) were not in place and 29.85% (20/67) were in place. Except patients who could not be contacted, all the other patients were consistent with the results of the survey conducted by the prevention and control agencies (56.72% and 38/67). The reason was that the feedback was not received by the feedback personnel (45.00%, 9/20), and the patient was in the original “ (10.00%, 2/20) and underfunding (10.00%, 2 ”) were not able to change the feedback result (20.00%, 4/20) due to special report system failure / 20). In the experimental group, the intervention rate was 82.62% (233/282), significantly higher than that of the control group (62.47%, 112/179). The difference was statistically significant (χ ~ 2 = 23.39, P <0.001). Conclusion The patients were feedback “not in place ” The main reasons for the lack of mission, to an independent designated medical institutions, to move to the lack of responsibility, targeted interventions effective and feasible.