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目的探讨医防合作结核病防治模式下定点医院的选择条件,为制定我国定点医院工作指导意见提供参考依据。方法 2010年6月招募6个定点医院模式试点地区的卫生行政部门人员、结防机构和医疗机构的管理人员和业务人员进行个人深入访谈。结果研究对象认为,位置、覆盖范围和区域内数量合适的二级或县区级医院作为定点医院较为合适,三级或市级医院作为定点医院不利于医防合作的协调管理且造成该类医院的医疗资源更加紧张;定点医院位置太偏远或覆盖范围过大会影响患者就诊积极性和治疗依从性;区域内定点医院数量过多会造成病源分散且浪费医疗资源。结论在县区级结防机构作为结核病防治规划执行主体的背景下,二级或县区级医院较三级或市级医院更适合作为医防合作结核病防治模式的定点医院,同时还需要综合考虑定点医院的位置、覆盖范围及区域内设置数量。
Objective To explore the selection conditions of designated hospitals under the mode of prevention and treatment of tuberculosis in medical cooperation and prevention and to provide a reference for the formulation of guidance for the work of designated hospitals in our country. Methods In June 2010, recruits were recruited to conduct in-person interviews with personnel of health administrative departments in six pilot hospitals in designated fixed-point hospitals, supervisors and medical staff of prevention and control institutions and medical institutions. Results The research object is that the second-level or county-level hospitals of the right size, location and coverage in the region are more suitable as designated hospitals, and the third-level or municipal-level hospitals as the designated hospitals are not conducive to the coordinated management of medical cooperation and prevention and result in such hospitals Of the medical resources are more tense; the fixed-point hospital is too remote or the coverage is too large to affect the patient’s enthusiasm for treatment and compliance with treatment; and if the number of designated hospitals in the area is too large, the source of the disease can be dispersed and the medical resources are wasted. Conclusions In the context of county-level prevention and control agencies as the executive body of tuberculosis prevention and control programs, the second-level or county-level hospitals are more suitable than the third-level or municipal-level hospitals as designated hospitals for prevention and control of TB prevention and treatment programs. At the same time, Location of designated hospitals, coverage and the number of regional settings.