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目的调查了解北京市非结防机构报告肺结核患者的转诊和到位现状,分析患者未到结防机构就诊的影响因素。方法采用现况研究方法,利用自行设计的《非结防机构报告肺结核患者转诊情况调查问卷》,对全市16个区2013年10-12月份非结防机构报告的活动性肺结核患者进行问卷调查,分析非结防机构转诊现状和患者未到结防机构就诊的影响因素。应用SPSS 18.0软件进行统计学分析,分类资料采用χ2检验,多分类有序变量使用秩和检验,多因素采用非条件logistic回归分析,P<0.05为差异有统计学意义。结果多因素分析显示,外地户籍(OR=1.85,95%CI:1.46~2.33)、报告医院类型为专科医院(OR=3.52,95%CI:2.79~4.45)、医生未进行转诊(OR=1.28,95%CI:1.01~1.62)、医生未进行免费政策宣教(OR=1.45,95%CI:1.15~1.82)、患者不相信结防机构诊疗水平(OR=2.71,95%CI:2.18~3.36)、城镇职工医保患者(OR=1.53,95%CI:1.13~2.07)、城镇居民医保患者(OR=2.50,95%CI:1.65~3.80)为患者不倾向到位结防机构的因素,变量剔除标准为P>0.05。结论针对上述因素,应在流动人口、健康教育、专防合作等重点领域加强肺结核患者的到位管理。
Objective To investigate the referral status and the status quo of TB cases reported by non-TB prevention and control agencies in Beijing and to analyze the influencing factors of TB patients without TB treatment. Methods A questionnaire survey of patients with pulmonary tuberculosis reported by non-prevention institutions in 16 districts of the city from January to December 2013 was conducted by using current research methods and self-designed Questionnaire on Non-TB Prevention and Control Agency Report on Referral of Tuberculosis Patients , Analysis of non-node institutions referral status and the patient did not arrive at the end of the impact of institutional treatment. SPSS 18.0 software was used for statistical analysis, classification data usingχ2 test, multi-class ordered variables using rank sum test, multivariate non-conditional logistic regression analysis, P <0.05 for the difference was statistically significant. Results Multivariate analysis showed that the number of registered permanent residents (OR = 1.85, 95% CI: 1.46-2.33) and hospital type of specialized hospitals (OR = 3.52, 95% CI: 2.79-4.45) (OR = 1.45, 95% CI: 1.15-1.82). The patients did not believe in the level of diagnosis and treatment of tuberculosis prevention and treatment institutions (OR = 2.71, 95% CI: 2.18 ~ (OR = 1.53, 95% CI: 1.13-2.07), and urban residents Medicare patients (OR = 2.50,95% CI: 1.65-3.80) were the factors that the patients did not tend to be in the TB institutions. The variables Exclusion criteria were P> 0.05. Conclusion In view of the above factors, the management of patients with tuberculosis should be strengthened in such key areas as floating population, health education and special cooperation.