论文部分内容阅读
目的探索更有效的结核病防控模式。方法整理湖北省宜昌市2012-2014年结核病控制规划专项调查资料,采用新的多渠道筹资支付模式,运用荧光(LED)显微镜取代传统光学显微镜,用基因芯片(GeneChip)技术取代传统的固体培养耐药检测技术,应用手机管理、家庭督导员管理和医务人员管理等多种手段并举开展患者治疗管理工作。率的比较采用χ~2检验,计量资料比较采用t检验,P<0.05为差异有统计学意义。结果结核病患者对政策满意度达到85.00%(68/80),其中门诊患者满意度100.00%(26/26),住院患者满意度77.78%(42/54),差异有统计学意义(χ~2=5.51,P<0.05)。LED显微镜技术使涂阳患者发现人数提高了11.78%。传统固体培养技术等待耐药结果时间(72.08±1.10)d,GeneChip技术等待耐药结果时间(8.00±4.41)d,差异有统计学意义(t=23.285,P<0.01)。采用手机管理、医务人员、家庭督导员等多种手段进行患者治疗管理,使自服药率从50.80%降至1.69%。结论新型结核病防控模式取得较好效果,建议推动地方政府指导定点医疗机构转型,结合当地具体情况制定结核病诊治医疗配置。
Objective To explore more effective prevention and control of tuberculosis. Methods The survey data of TB control program in 2012-2014 in Yichang, Hubei province were compiled. A new multi-channel funding mode was adopted. Fluorescent (LED) microscope was used to replace traditional light microscope and GeneChip was used to replace traditional solid culture Drug testing technology, the application of mobile phone management, family supervisor management and medical personnel management and other means simultaneously carry out patient treatment management. Rate comparison using χ ~ 2 test, measurement data were compared using t test, P <0.05 for the difference was statistically significant. Results The satisfaction rate of TB patients was 85.00% (68/80), including outpatient satisfaction 100.00% (26/26) and inpatient satisfaction 77.78% (42/54), the difference was statistically significant (χ ~ 2 = 5.51, P <0.05). LED microscopy increased the number of smear-positive patients by 11.78%. The traditional solid culture technology waited for the drug resistance time (72.08 ± 1.10) d, while the GeneChip technology waited for the drug resistance time (8.00 ± 4.41) d, the difference was statistically significant (t = 23.285, P <0.01). The use of mobile phone management, medical staff, family supervisors and other means of patient treatment management, self-medication rate decreased from 50.80% to 1.69%. Conclusion The new model of tuberculosis prevention and control has achieved good results. It is suggested that local governments guide the transformation of designated medical institutions and formulate the diagnosis and treatment of TB according to the local conditions.