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目的了解四川省全球基金项目多次抗结核治疗的结核病患者寻求医疗服务的经历及其治疗的医疗费用,为今后结核病防治工作提供参考。方法采用分层整群抽样的方法,在四川省全球基金项目地区抽取1个区、1个县作为研究现场,采用自行设计的调查问卷对2011-04/08期间所有就诊的既往有过2次及以上抗痨治疗史的结核病患者进行调查。结果共调查81名患者,分别有71.6%和91.4%的结核病患者首次和第2次治疗在县疾控中心进行,88.7%结核病患者在第1次治疗中使用国家推荐的初治方案,70%的患者在第2次治疗中按复治方案完成。18.8%和14.8%的患者在第1次或第2次治疗中未能按国家推荐的相应方案完成治疗。首次治疗和再次治疗的结核病患者的医疗费用的中位数分别为800和1200元,低收入家庭的结核病治疗负担较重,支出的治疗费用占家庭人均收入的比例远远高于高收入家庭(P<0.05)。结论结核病患者能够及时到定点机构就诊,但是依然面临较重的经济负担,应重视对居民的健康教育,加强对结核病患者的管理。
Objective To understand the experience of seeking medical services and the medical treatment cost of tuberculosis patients with multiple anti-TB treatments in the Sichuan Global Fund Project for many times and to provide reference for future tuberculosis prevention and control work. Methods A stratified cluster sampling method was used to select one district and one county as the research site in the global fund project area of Sichuan Province. The survey questionnaire designed by ourselves was used twice for all visits from 2011 to August 08 And anti-tuberculosis treatment history of patients with tuberculosis were investigated. Results A total of 81 patients were surveyed. Among them, 71.6% and 91.4% of tuberculosis patients were treated for the first and second treatments at the CDC, 88.7% of tuberculosis patients were treated with the nationally recommended initial treatment regimen in the first treatment, 70% Of patients in the second treatment according to rehabilitation program to complete. 18.8% and 14.8% of patients in the first or second treatment failed to complete the treatment corresponding to the national program. Median TB costs for first-time and second-time TB patients were $ 800 and $ 1,200, respectively. Low-income families had a higher burden of TB treatment, and the cost of spending on treatment was significantly higher than that of high-income households P <0.05). Conclusion Tuberculosis patients can go to designated agencies in time, but still face a heavy financial burden, and should pay more attention to the health education of residents and strengthen the management of tuberculosis patients.