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背景:1995年意大利进行了一项全国性的包括203家管理结核病人的肺病中心(144家有结核病床位的医院肺病中心和59家门诊肺病中心)的调查。目的:为了评价1)住院情况(入院出院标准,住院时间)作为初始目标;2)床位的可获得性,为减少感染的传播所采取的预防措施以及住院病人的来源和出院后对结核病患者的随访手段作为第二目标。设计:将一份含有26项内容的调查表分别寄给203家肺病中心。结果:167家肺病中心对调查表进行了反馈(82.3％),其中159份调查表可用于分析(110份来自医院肺病中心,49份来自门诊肺病中心)。各肺病中心所采用的结核病患者收住院的标准是:全部结核病患者占47％;仅涂阳肺结核病患者占14％;有临床问题的结核病患者占39％。医院肺病中心住院的涂阴肺结核和肺外结核患者明显较多。在所有病例中,平均71.6％的患者住院(医院肺病中心为88.2%,门诊肺病中心为28％)。涂阳肺结核病人平均住院为34天,涂阴肺结核病人为20天,肺外结核病人为21.5天。61%的医院肺病中心把痰菌阴转作为规定的出院标准。结论:从现行政策(大部分患者较长时间住院)向门诊治疗政策转变需要科学界和卫生行政机构共同协调教育工作。
Background: In 1995, Italy conducted a nationwide survey of 203 lung disease centres managing TB patients (144 hospitals with TB beds and 59 outpatients with lung disease). OBJECTIVE: To evaluate 1) the status of hospitalization (discharge standard, hospital stay) as the initial goal; 2) availability of beds, prevention measures taken to reduce the spread of infection, and the source of inpatients and patients who are discharged from hospitals after tuberculosis Follow-up measures as a second goal. Design: Send a questionnaire containing 26 items to 203 lung disease centers. RESULTS: A total of 167 lung disease centers responded (82.3%) to the questionnaire, of which 159 questionnaires were available for analysis (110 from the hospital’s lung disease center and 49 from the outpatient lung disease center). The criteria for hospitalization of tuberculosis patients adopted by various lung disease centers were: total tuberculosis patients accounted for 47%; only smear-positive tuberculosis patients accounted for 14%; clinical problems with tuberculosis accounted for 39%. There were significantly more patients with smear-negative tuberculosis and extrapulmonary tuberculosis hospitalized at the hospital’s lung disease center. In all cases, an average of 71.6% of patients were hospitalized (88.2% for hospital lung disease centers and 28% for outpatients with lung disease centers). The average hospitalization of smear-positive tuberculosis patients was 34 days, smear-negative tuberculosis patients were 20 days, and extrapulmonary tuberculosis patients were 21.5 days. 61% of the hospital’s lung disease centers turned the sputum negative as a prescribed discharge criterion. Conclusion: From the current policy (the majority of patients stay in hospital for a long time) to the outpatient treatment policy changes need the scientific community and the health administration agencies to coordinate education.