目的对宜昌市县两级结核病定点医院开展诊疗服务情况进行专项调查,为进一步提高其工作质量提供科学依据。方法选择4家定点医院采用问卷调查与病案调查相结合的方法进行研究。结果 2012—2014年期间,地市级定点医院门诊人次数持续增长,出院人次数2013年增长了10.00%,但2014年有所下降,增长率为-11.00%,3年期间结核病床使用率均超过100.00%;县级定点医院中,五峰县人民医院年门诊人次持续增长,枝江及宜都人民医院在2014年门诊人数均明显下降,3个县级定点医院出院人次数均在2014年出现了负增长。2014年4家医院住院肺结核患者1 218例中,合理方案使用率为58.87%,地市级定点医院合理方案使用率低于县级定点医院;38.10%的患者使用了二线抗结核药物,地市级定点医院使用率最高,占47.54%,二线药物中以氟喹诺酮类为主,占35.22%。结论要进一步规范结核病定点医院诊疗服务工作,充分发挥其资源优势。 Objective To conduct a special investigation on the diagnosis and treatment service of designated TB hospitals in Yichang City and counties to provide scientific basis for further improving the quality of their work. Methods Four fixed-point hospitals were selected to conduct a study using a combination of questionnaires and medical records. Results During 2012-2014, the number of outpatients at designated cities and prefecture hospitals continued to increase. The number of discharged patients increased by 10.00% in 2013 but declined in 2014 with a rate of increase of -1.00%. Both the utilization rate of TB beds during the three-year period Over 100.00%. Of the designated hospitals in Wufeng County, the annual outpatient visits of Wufeng County People’s Hospital continued to increase. The number of outpatients in Zhijiang and Yidu People’s Hospital decreased significantly in 2014, and the number of discharged persons in the three county-level designated hospitals all appeared in 2014 Negative growth. Among 1 218 cases of hospitalized tuberculosis patients in 4 hospitals in 2014, the rational program utilization rate was 58.87%, and the rational program utilization rate of designated hospitals in prefecture-level cities was lower than that of designated hospitals in county-level hospitals; 38.10% of patients used second-line anti-tuberculosis drugs, The highest fixed hospital utilization rate was 47.54%, the second-line drugs were mainly fluoroquinolones, accounting for 35.22%. Conclusion It is necessary to further standardize the diagnosis and treatment services of designated hospitals in TB and give full play to their resource advantages.