论文部分内容阅读
目的了解和评价2010-2014年四川省非户籍人口肺结核病跨区域防治管理工作实施情况,探索制约该人群利用公共卫生服务的制度缺陷,为完善其跨区域管理工作提出对策。方法采用定量分析的方法,通过结核病专报信息系统收集四川省21个市州非户籍人口和户籍人口肺结核患者资料进行统计分析。结果 2010-2014年四川省登记户籍人口活动性肺结核患者288 976例,非户籍人口活动性肺结核患者11 005例。非户籍患者来源主要以转诊(34.03%)和追踪(32.86%)为主;在四川省转出的140例非户籍患者中,未反馈率、到位率、代管率均高于转入的1 142例非户籍患者(P=0.001;P=0.024;P=0.028),转出的非户籍人口患者到位率低于户籍人口患者(χ~2=15.558,P=0.001),转出患者在西部地区反馈时间最长,中位数为21 d;非户籍人口新涂阳肺结核患者治疗满1年后丢失率高于户籍人口新涂阳患者(χ~2=20.372,P=0.001),非户籍人口新涂阳肺结核患者完成治疗率在5年间有提高趋势(趋势χ~2=7.768,P=0.005)。结论肺结核患者跨区域管理程序实施是保证非户籍人口肺结核患者持续治疗的有效措施,结核病专报信息系统的管理功能可基本满足工作需要,各级结核病防治机构特别是西部地区应尽力强化督导与协作,加强对非户籍人口患者健康宣传力度,确保该工作顺利开展。
Objective To understand and evaluate the implementation of cross-border TB control in non-household population in Sichuan from 2010 to 2014, explore the institutional defects that restrict the population’s use of public health services, and propose measures to improve cross-regional management. Methods Quantitative analysis method was used to collect the data of tuberculosis patients from non-household population and household population of 21 municipalities in Sichuan Province through the TB special information system for statistical analysis. Results In 2010-2014, 288 976 cases of active pulmonary tuberculosis were registered in the registered population of Sichuan Province and 11 005 cases of active tuberculosis of non-registered population. The main sources of non-household registration were referral (34.03%) and follow-up (32.86%). Among the 140 cases of non-household registration transferred out in Sichuan Province, the non-feedback rate, the place rate and the escrow rate were higher than those transferred (P = 0.001; P = 0.024; P = 0.028). The out-of-place rate of non-household population was lower than that of household population (χ ~ 2 = 15.558, P = 0.001) The longest feedback time in the western region was 21 days. The loss rate of new smear-positive pulmonary tuberculosis patients after one year treatment was higher than that of the newly smear-positive patients (χ ~ 2 = 20.372, P = 0.001) The rate of completion of new smear-positive pulmonary tuberculosis patients in household population tended to increase over the 5-year period (trend χ ~ 2 = 7.768, P = 0.005). Conclusion The implementation of trans-regional management procedures for tuberculosis patients is an effective measure to ensure continuous treatment of tuberculosis patients in non-registered population. The management function of TB special information system can basically meet the needs of work. TB control agencies at all levels, especially the western region, should make every effort to strengthen supervision and coordination , Strengthen the health promotion of patients with non-registered population to ensure the smooth progress of the work.