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目的 :评价上海市在过去 3年中有关的性病政策对性病服务质量的影响 ,为有关决策者提供科学依据。方法 :于 1996年和 1999年两次对上海市徐汇区公立的性病服务机构进行了评估 :采用定性和定量相结合的研究方法 ,并以统一的问卷对所有性病服务机构进行调查 ,以统一的访谈提纲对部分机构进行深入访谈 ;定量资料用 SAS软件分析。结果 :1999年全部 2 1所性病防治机构配备了性病专科医生 ,而 1996年 19个机构中仅有 2 0 %配备了专科医生 ;1999年有 85 .9%的临床医生和 95 .2 %的实验室人员接受了性病专科培训 ,而 1996年分别为 40 .0 %和 36 .4% ;1999年所有性病服务门诊装备了必要的设备 ,而 1996年为 73.7% ;病史记录和性伴同治率明显上升 ,同时开展了淋病、衣原体和 HIV检测的机构比例明显增加 (P<0 .0 5 ) ;各医疗机构均开展了对梅毒、淋病、衣原体、支原体和尖锐湿疣的治疗 ,但梅毒和尖锐湿疣的治疗费用明显上升 (P<0 .0 5 ) ;1999年 90 .5 %的门诊提供了咨询服务 ,40 %建议使用避孕套 ,34 .8%建议性伴同治。结论 :本研究提示 ,在过去的 3年中 ,该区的性病防治服务质量得到明显改善 ,三级性病防治网络发挥了重要作用 ,在今后的卫生体制改革中应加强其功能。
Objectives: To evaluate the impact of related sexually transmitted diseases policies on the quality of STI services in Shanghai over the past three years and to provide scientific basis for relevant decision makers. Methods: Two public health STI services in Xuhui District of Shanghai City were evaluated in 1996 and 1999: qualitative and quantitative research methods were used, and all STI services were investigated with a uniform questionnaire to achieve a unified Interview outlines conduct in-depth interviews with some institutions; quantitative data are analyzed with SAS software. Results: In 1999, all 21 STDs were equipped with STD specialists. In 1996, only 20% of the 19 agencies were equipped with specialists; in 1999, there were 85.9% of clinicians and 95. 2% of Laboratory personnel received specialist training in STDs, which was 40.0% and 36.4% respectively in 1996; all STD clinics were equipped with the necessary equipment in 1999, compared with 73.7% in 1996; medical records and partner co-treatment rates Significantly increased, while the proportion of institutions carrying out tests for gonorrhea, chlamydia, and HIV was significantly increased (P < 0.05); all medical institutions have carried out the treatment of syphilis, gonorrhea, chlamydia, mycoplasma, and condyloma acuminata, but syphilis and sharp The cost of treatment for wet sputum increased significantly (P<0.05); in 1999, 95.5 percent of outpatients provided counseling services, 40 percent recommended condom use, and 34.8% recommended that their partners have the same treatment. Conclusion: This study suggests that in the past three years, the quality of sexually transmitted disease prevention services in the region has been significantly improved, and tertiary prevention and control networks have played an important role in strengthening the function of health system reforms in the future.