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目的了解和评价浙江省流动人口肺结核患者跨区域管理的现况,为进一步完善跨区域管理程序和管理机制提供科学依据。方法采用现况调查和定性访谈相结合的方法,对浙江省2011年肺结核患者转出转入数量较多的8个县区进行流动人口肺结核患者跨区域管理的信息调查和现场访谈。现况调查主要通过结核病患者登记本、肺结核患者转出单及病案等信息记录患者转出的信息,与专报系统的转出管理情况进行核对,评价跨区域肺结核患者管理的工作质量。采用SPSS 13.0、Excel 2003等统计软件对审核后的数据进行录入与统计分析,率的比较采用χ2检验,P<0.05为差异有统计学意义。结果调查地区转入患者占当地患者的6.1%,转出占9.0%,转出患者到位率64.1%,转入患者到位率80.3%。转入地与转出地病人到位反馈率分别为94.2%、83.6%,没有明显的差异;转入地后期随访2月末、5月末、6(8)月末痰检信息、疗程结束信息反馈率分别为90.3%、89.5%、97.6%、100.0%,转出地后期随访2月末、5月末、6(8)月末痰检信息、疗程结束信息反馈率分别为47.9%、60.7%、63.2%、69.7%,转入县的各项后期随访信息反馈率要明显高于转出县。随访治疗结果各项反馈情况总体上全球基金项目县要比非项目县规范,项目县转出患者平均反馈时间(33.9d)要比非项目县(53.4d)及时。访谈结果表明,研究地区结核病防治工作人员和患者普遍认为需要加强流动人口肺结核患者跨区域管理,但在执行过程中仍存在一些困难和问题。结论针对发现的问题和挑战,应有针对性、系统性的落实相关工作措施,进一步完善流动人口肺结核患者跨区域管理程序和管理机制。
Objective To understand and evaluate the current situation of trans-regional management of pulmonary TB patients in floating population in Zhejiang Province and provide scientific basis for further improvement of cross-regional management procedures and management mechanism. Methods Using the method of combining current situation survey and qualitative interview, the information survey and on-the-spot interview about transnational management of migrant pulmonary tuberculosis among migrant patients in Zhejiang province in 2011 were carried out and transferred into 8 counties with large number. Status quo survey mainly through the registration of patients with tuberculosis, tuberculosis patients out of a single and medical records and other information recorded out of the patient information, and special reporting system to check out the management of transfer, evaluation of cross-regional tuberculosis patient management quality of work. Statistical software SPSS 13.0, Excel 2003 and other data were used to input and statistical analysis of the data after the audit. Rates were compared using χ2 test, P <0.05 was considered statistically significant. Results In the surveyed regions, 6.1% of the patients transferred to the area and 9.0% of the patients transferred out of the survey area, 64.1% of the patients transferred out of the area and 80.3% of the transferred patients. There was no obvious difference in the feedback rate of patients who transferred to and from place to place, respectively, 94.2% and 83.6%, respectively; late follow-up of the transfer to the end of February, the end of May, the end of 6 (8) (90.3%, 89.5%, 97.6%, 100.0%). The feedback rate of sputum examination information and end of treatment at the end of the last two months, the end of May and the end of May (6) were 47.9%, 60.7%, 63.2% and 69.7 %, All the follow-up information feedback rate into the county was significantly higher than the transfer of the county. Feedback of Follow-up Treatment Results Generally speaking, the global fund project counties are higher than those of non-project counties, and the average feedback time (33.9d) transferred from project counties is faster than that of non-project counties (53.4d). Interviews showed that there was a general consensus among TB control workers and patients in study areas that there was a need to strengthen trans-regional management of TB patients among floating population. However, there are still some difficulties and problems in implementation. Conclusion In response to the problems and challenges found, relevant measures should be implemented in a systematic and targeted manner to further improve cross-regional management procedures and management mechanisms for TB patients with floating population.