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目的通过改善医院医务人员认知和行为、健全工作制度等干预措施,扩大对就诊患者HIV筛查覆盖,加强对HIV筛查阳性患者的告知和信息的收集,提高筛查阳性患者随访比例。方法选择长沙市某部级三甲医院,通过医务科在医院内部对各科室临床医生的系统培训,在工作环境内以告示、宣传栏等形式反复提醒,增强临床医生主动为就诊患者提供HIV筛查的意识,同时规范院内筛查患者的信息登记、随访、确证流程等制度。通过15个月的干预工作,比较工作开展前后同时间段内该医院HIV筛查人次数占就诊总人次数比例(筛查率)、HIV筛查阳性患者脱失率,并分析影响HIV筛查阳性患者脱失的其他原因。结果干预工作实施前后HIV筛查率上升0.48%(P<0.01),HIV筛查阳性患者脱失率下降20.37%(P<0.01)。住院病人参加确诊检测比例高于门急诊患者(P<0.05),年龄、性别、住址对是否参加确诊无影响(P>0.05)。结论扩大筛查更多地发现了感染者,通过安排专人负责HIV筛查阳性的后续处理工作,利于降低HIV筛查阳性患者脱失率。
Objective To improve the coverage of HIV screening in treatment patients, strengthen the collection of information and information on HIV screening positive patients by improving the cognition and behavior of hospital medical staff, improve the work system and other aspects, and increase the follow-up proportion of screening positive patients. Methods A departmental top three hospital in Changsha was selected to systematically train clinicians in various departments of the hospital through the medical department and reminded repeatedly in the working environment in the form of notices and billboards to enhance clinicians’ initiative to provide HIV screening for the patients Awareness, at the same time regulate the screening of patients in the hospital information registration, follow-up, confirmation process and other systems. Through a 15-month intervention, the proportion of HIV screening persons (screening rate) in the hospital during the same period before and after the work was compared with that of HIV-positive screening patients and the impact of HIV screening Other reasons for the loss of positive patients. Results Before and after the intervention, HIV screening rate increased by 0.48% (P <0.01), and HIV screening positive rate of patients lost 20.37% (P <0.01). The proportion of inpatients attending confirmed diagnosis was higher than that of outpatient and emergency (P <0.05). There was no significant difference in the age, gender, and address of patients (P> 0.05). Conclusion The expanded screening has found more people infected. It helps to reduce the loss rate of HIV screening positive patients by arranging special staff to handle the follow-up of HIV screening positive.