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目的分析甘肃省武威市凉州区结核病防治服务新体系转型前后工作实施效果,为结核病防治工作的可持续发展提供科学依据。方法 2017年3月收集2013年9月8日─2017年2月武威市凉州区结核病防治工作的各类报表和基础资料,应用Excel建立数据库,采用Spss 17.0软件进行统计学分析,描述凉州区结核病防治服务新体系实施效果。结果 2015年6月武威市凉州区实施结核病防治服务新体系后,定点医院结核病防治专业技术人员数量较新体系实施前增加了1.73倍,但学历(χ~2=0.41)和职称(χ~2=1.93)无明显改善(均P>0.05);2016年初诊肺结核病可疑者就诊率较2014年明显下降,差异有统计学意义(χ~2=289.43,P<0.05);初诊肺结核病可疑者查痰率无明显变化,差异无统计学意义(χ~2=1.29,P>0.05);2016年肺结核病病人登记率较2014年下降明显,差异有统计学意义(χ~2=37.74,P<0.05);新发涂阳肺结核病病人比例下降(χ~2=3.94,P<0.05),复治涂阳(χ~2=0.38)和初治涂阴(χ~2=0.67)肺结核病病人比例均无明显变化(P>0.05);重症涂阴肺结核病病人比例升高,差异有统计学意义(χ~2=17.00,P<0.05)。结论武威市凉州区自推行结核病防治服务新体系以来,初诊肺结核病可疑者就诊率和肺结核病病人登记率下降,应强化定点医院的公共卫生职责,并加大补偿力度,逐步实现肺结核病病人诊疗零负担,鼓励病人去定点医院接受规范治疗,以控制肺结核病的发病和流行。
Objective To analyze the implementation results of the new TB system in Liangzhou District of Wuwei City, Gansu Province before and after the transformation and provide a scientific basis for the sustainable development of tuberculosis prevention and control work. Methods March 2017 Collection of various reports and basic information on tuberculosis prevention and control work in Liangzhou District, Wuwei City, from September 8, 2013 to February 2017, the database was established by Excel and the statistical analysis was conducted by using Spss 17.0 software to describe Liangzhou District TB prevention and treatment services system implementation effect. Results After implementing the new TB prevention and treatment system in Liangzhou District in Wuwei City in June 2015, the number of TB specialists in designated hospitals increased by 1.73 times compared with that before the implementation of the new system. However, education background (χ ~ 2 = 0.41) and professional title 2 = 1.93) (all P> 0.05). The prevalence of suspected tuberculosis in early 2016 was significantly lower than that of 2014 (χ ~ 2 = 289.43, P <0.05); the newly diagnosed tuberculosis was suspicious (Χ ~ 2 = 1.29, P> 0.05). The registration rate of pulmonary tuberculosis patients in 2016 decreased significantly compared with that of 2014, with significant difference (χ ~ 2 = 37.74, (Χ ~ 2 = 3.94, P <0.05). The rates of smear positive smear (χ ~ 2 = 0.38) and initial smear negative smear (χ ~ 2 = 0.67) of patients with pulmonary tuberculosis There was no significant difference between the two groups (P> 0.05). The proportion of patients with smear negative pulmonary tuberculosis was significantly higher (χ ~ 2 = 17.00, P <0.05). Conclusions Since the implementation of a new TB prevention and treatment service system in Liangzhou District of Wuwei City, the number of newly diagnosed TB patients and the decrease of TB registration rate should be strengthened. Public health responsibilities of designated hospitals should be strengthened and compensation should be increased to gradually achieve TB patients Zero burden of treatment, to encourage patients to go to designated hospitals for standardized treatment to control the incidence and prevalence of tuberculosis.