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目的探讨跨区域管理肺结核患者的到位情况及影响因素,为优化跨区域管理机制、提高治疗效果提供理论依据。方法以2009~2013年深圳市宝安区跨区域管理的肺结核患者为研究对象,比较转诊到位与未到位患者在人口学特征、诊断结果、转入转出信息等方面的差异,同时采用非条件Logistic回归分析探讨影响跨区域转诊到位的主要因素。结果 2009~2013年深圳市宝安区跨区域管理肺结核患者的转诊到位率为77.15%。到位与未到位患者在年龄、职业、离开时状态、转出前治疗时间、患者及联系人电话填写完整性的构成方面比较差异有统计学意义(P<0.05);多因素非条件Logistic回归分析显示,患者及联系人电话填写完整和转出前治疗时间>30 d与患者到位显著相关,OR(95%CI)分别为12.162(1.481,99.848)和0.109(0.031,0.383)。结论患者及联系人电话填写完整是跨区域转诊患者到位的保护因素,转出前治疗时间>30 d是危险因素,相关部门应根据影响患者到位的主要因素,采取针对性措施。
Objective To explore the situation and influential factors of tuberculosis management across regions and to provide theoretical basis for optimizing trans-regional management mechanism and improving treatment effect. Methods From 2009 to 2013, the patients with tuberculosis managed in Bao’an District of Shenzhen City across regions were compared. The difference between demographic characteristics, diagnosis results, transfer-out information and so on was compared between patients with referral and those without referral. At the same time, Logistic regression analysis to explore the main factors affecting the trans-regional referral in place. Results Between 2009 and 2013, the referral rate of trans-regional management of TB patients in Shenzhen Baoan District was 77.15%. The patients in and out of place had significant differences in age, occupation, state before leaving, treatment time before transfer, telephone and telephone composition integrity of patients and contacts (P <0.05), and multivariate non-conditional logistic regression analysis Patient and contact telephone numbers were complete and pre-transfer treatment> 30 days were significantly associated with patient placement, with OR (95% CI) of 12.162 (1.481, 99.848) and 0.109 (0.031, 0.383), respectively. Conclusions Telephone and phone numbers of patients and contacts are complete protection factors for cross-regional referral of patients. Treatment time> 30 days before the transfer is a risk factor. Relevant departments should take targeted measures according to the main factors that affect the patients in place.