深圳市宝安区和龙岗区非结防机构网络报告肺结核患者转诊未到位影响因素分析

结核病与肺部健康杂志 ›› 2012, Vol. 1 ›› Issue (3): 176-179.

深圳市宝安区和龙岗区非结防机构网络报告肺结核患者转诊未到位影响因素分析

方兰君,周琳,李建伟,蒋莉,潘绮丽,钟球

510630 广州, 广东省结核病控制中心门诊部(方兰君、潘绮丽),主任办公室(周琳、钟球),科教信息科(李建伟、蒋莉)

收稿日期:2012-10-12 出版日期:2012-12-20 发布日期:2012-12-20
通信作者: 钟球,Email:gdtb@vip.163.com
基金资助:
“十一五”国家科技重大专项(2008ZX1003-007)

Factors impacting on not arriving at TB dispensaries of TB cases reported and referred by non-TB control institutions in Baoan and Longgang districts of Shenzhen

FANG Lan-jun, ZHOU Lin, LI Jian-wei, JIANG Li, PAN Qi-li, ZHONG Qiu

Center for Tuberculosis Control and Prevention of Guangdong Province, Guangzhou 510630, China

Received:2012-10-12 Online:2012-12-20 Published:2012-12-20
Contact: ZHONG Qiu,Email:gdtb@vip.163.com

摘要/Abstract

摘要： 目的分析深圳市宝安区和龙岗区非结核病防治机构(简称“结防机构”)网络报告肺结核患者转诊未到位的影响因素,为制定加强该区域综合医院与结核病防治机构合作的政策和措施提供参考依据。方法对2010年5—7月宝安区和龙岗区60例转诊到位和60例转诊未到位患者,采用问卷调查的方式进行成组设计病例-对照研究,对数据进行χ²检验,P<0.05为差异有统计学意义。结果未到位组的转诊医生未开具转诊单13例(21.7%,13/60),与到位组5例(8.3%,5/60)比较差异有统计学意义(χ²=4.18,P<0.05);患者知道结防机构是诊治结核病的专业机构51例(85.0%,51/60),与到位组59例(98.3%,59/60)比较差异有统计学意义(χ²=6.98,P<0.01);患者知道结防机构的位置44例(73.3%,44/60),与到位组59例(98.3%,59/60)比较差异有统计学意义(χ²=15.42,P<0.01);患者相信结防机构的诊疗水平36例(60.0%,36/60),与到位组54例(90.0%,54/60)比较差异有统计学意义(χ²=14.4,P<0.01);患者相信结防机构提供的免费抗结核药物的治疗效果18例(30.0%,18/60),与到位组48例(80.0%,48/60)比较差异有统计学意义(χ²=30.3,P<0.01);患者认为去结核病防治机构交通不方便54例(90.0%,54/60),与到位组32例(53.3%,32/60)比较差异有统计学意义(χ²=19.86,P<0.01)。结论深圳市宝安区和龙岗区非结防机构网络报告肺结核患者转诊未到位的主要影响因素为转诊医生未开具转诊单,结防机构未能充分宣传国家结核病免费政策和机构自身,以及到结防机构交通不方便。

Abstract: Objective To identify the factors impacting on not arriving at TB dispensaries (TD) of TB cases reported and referred by non-TB control institutions (NTI) in Baoan district and Longgang district of Shenzhen, and provide the evidence for developing policies to strengthen PPM. Methods During May to July 2010, 60 cases from Baoan and Longgang who arrived at TD and 60 cases who were reported in the same districts but didn’t arrived at TD were recruited to receive questionnaire interviews as control and case groups respectively. Chi-square test was used for analysis, and the difference had statistical significance if P<0.05. Results In non-arrival group, physicians in NTI did not issue referral sheets to 13 cases (21.7%, 13/60), while in arrival group the number was 5 cases (8.3%, 5/60), and the difference had statistical significance (χ²=4.18, P<0.05). The proportion of patients knowing TD was the professional institute for tuberculosis diagnosis and treatment in non-arrival group (85.0%, 51/60) was less than that from arrival group of (98.3%, 59/60), with statistical significance (χ²=6.98, P<0.01). The proportion of cases knowing the place of TD (73.3%, 44/60) in non-arrival group was significantly lower than arrival group (98.3%, 59/60) (χ²=15.42, P<0.01). Less patients trusted the TD’s capability of diagnosis and treatment (60.0%, 36/60) in non-arrival group than arrival group (90.0%,54/60) (χ²=14.4, P<0.01). The significant difference also existed in the number of patients knowing curative effect of TB drugs provided by TD (30.0%,18/60 vs 80.0%,48/60, χ²=30.3, P<0.01). More proportion of patients in non-arrival group reported inconvenient transportation (90.0%, 54/60 vs 53.3%, 32/60). The difference was statistically significant (χ²=19.86, P<0.01). Conclusion The major factors affecting the arrival rate in Baoan district and Longgang district of Shenzhen were physicians in NTI not issuing referral sheets to cases, inadequate publicity of national free policy on tuberculosis and institutions themselves by TD, and inconvenient transportation.

方兰君,周琳,李建伟,蒋莉,潘绮丽,钟球. 深圳市宝安区和龙岗区非结防机构网络报告肺结核患者转诊未到位影响因素分析[J]. 结核病与肺部健康杂志, 2012, 1(3): 176-179.

FANG Lan-jun, ZHOU Lin, LI Jian-wei, JIANG Li, PAN Qi-li, ZHONG Qiu. Factors impacting on not arriving at TB dispensaries of TB cases reported and referred by non-TB control institutions in Baoan and Longgang districts of Shenzhen[J]. Journal of Tuberculosis and Lung Health, 2012, 1(3): 176-179.