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目的分析民营医院作为定点医院的新型结核病防治服务模式在结核病防治工作的实施效果,为实施新型结核病防治服务模式提供参考依据。方法选择重庆市采用民营医院作为定点医院模式和CDC模式的区各2个,收集分析人力资源、患者发现、转诊追踪、治疗转归、督导和抗结核药物使用等数据,探讨民营医院作为定点医院的新型结核病防治模式实施效果。结果两区县实施新型结核病防治模式前后,结防人员数量减少了近50%。民营医院模式和CDC模式下的肺结核登记率(分别为54.24/10万和62.98/10万)、系统管理率(分别为99.68%和98.37%)、转诊到位率(分别为30.16%和36.48%)、涂阳患者治愈率(分别为94.14%和93.18%)、涂阴患者完成疗程率(分别为98.23%和96.43%)、督导完成率(分别为104.11%和101.57%)和保肝药使用率(分别为80.39%和80.39%)的差异均无统计学意义(P>0.05)。而民营医院模式与CDC模式比较,总体到位率(分别为91.50%和71.19%)、追踪到位率(分别为87.49%和54.65%)和标准治疗方案执行率(分别为88.65%和99.02%)存在统计学差异(P<0.001)。结论民营医院作为定点医院的新型结核病防治模式是一个值得借鉴的结核病防治服务模式。加强医防合作,可有效提高结核病控制效果,降低结核病疫情。
Objective To analyze the implementation of tuberculosis prevention and treatment in private hospitals as a new type of tuberculosis prevention and treatment service in designated hospitals and to provide reference for the implementation of new tuberculosis prevention and treatment services. Methods Choosing 2 private hospitals in Chongqing as fixed-point hospitals and CDC models, collecting and analyzing data of human resources, patient discovery, referral and follow-up, treatment outcome, supervision and use of anti-TB drugs and so on, Hospital implementation of a new model of tuberculosis prevention and control. Results Before and after the implementation of the new model of tuberculosis prevention and control in the two districts and counties, the number of anti-tuberculosis personnel decreased by nearly 50%. (54.24 / 100000 and 62.98 / 100000 respectively), the system management rate (99.68% and 98.37% respectively) and the referral rate (30.16% and 36.48% respectively) in the private hospital mode and CDC mode, ), Cure rate of smear positive patients (94.14% and 93.18% respectively), cure rate of cured patients (98.23% and 96.43% respectively), completion rate of supervision (104.11% and 101.57% There was no significant difference in rates (80.39% and 80.39% respectively) (P> 0.05). However, the overall success rate (91.50% and 71.19% respectively), the tracking rate (87.49% and 54.65% respectively) and the standard treatment rate (88.65% and 99.02% respectively) were found between the private hospital model and the CDC model Statistical difference (P <0.001). Conclusion Private hospitals as a new type of tuberculosis prevention and control model at designated hospitals is a worthwhile service model for tuberculosis prevention and treatment. Strengthening medical cooperation with prevention and control can effectively improve the control effect of tuberculosis and reduce the outbreak of tuberculosis.