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目的对转诊未到位的肺结核患者进行调查,分析未到位的原因。方法采用整群抽样方法抽取海南省海口市、三亚市和屯昌县作为研究现场,对2008年6月～2009年5月间网络直报转诊未到位的肺结核患者进行问卷和追踪调查。结果共调查216例未转诊肺结核患者,未到结防机构诊治的原因:与医院因素有关者共有123例,占56.9%,其中因医生没说清楚的占53.7%、医生没有转诊的占34.1%、截留患者配药治疗的占8.9%、住院治疗的占3.3%;与患者因素有关的为93例,占43.1%,其中怕更多的人知道的占24.7%、工作忙的占23.6%、经济困难的占19.4%)、不相信结防机构的占17.2%、交通不便的占8.6%、找不到结防机构的占6.5%。结论肺结核患者转诊未到位影响因素中:归于患者原因占43.1%,主要是怕受到岐视;医院原因占56.9%,主要是医生没说清楚及没有转诊。因此要进一步加强结核病健康促进工作,提高结核病知晓率,不断加强与医疗机构的合作,增强医务人员责任心,提高肺结核患者到位率。
Objective To investigate the cases of pulmonary TB patients who did not refer to the hospital and analyze the reason why they are not in place. Methods A cluster sampling method was used to extract Haikou, Sanya and Tunchang counties in Hainan Province as research sites. Questionnaires and follow-up surveys were conducted on patients with pulmonary tuberculosis who did not refer to direct online reporting from June 2008 to May 2009. Results A total of 216 cases of untreated tuberculosis patients were investigated and did not reach the end of prevention and treatment of institutions of the reasons: with the hospital-related factors were a total of 123 cases, accounting for 56.9%, of which doctors did not make clear 53.7%, doctors did not refer to 34.1%, intercepted patients accounted for 8.9% of drug treatment, hospitalization accounted for 3.3%; and patient factors related to 93 cases, accounting for 43.1%, of which more people are afraid of fear of more than 24.7%, 23.6% , Accounting for 19.4% of the economic difficulties), did not believe that the prevention and control agencies accounted for 17.2%, traffic inconvenience accounted for 8.6%, can not find the prevention and control agencies accounted for 6.5%. Conclusion Among the influential factors of referral to TB patients, 43.1% were attributable to the patients, mainly due to fear of discrimination; 56.9% were hospital-related reasons, mainly because the doctors did not make clear and no referral. Therefore, further efforts should be made to promote the health promotion of tuberculosis, raise the awareness of tuberculosis, continuously strengthen cooperation with medical institutions, enhance medical staffs’ sense of responsibility and increase the rate of arrival of tuberculosis patients.