苏北农村地区结核病患者首诊机构选择和配置研究

Function of the first visited facilities of Tuberculosis patients and factors in access to different level facilities in northern rural Jiangsu

目的：比较农村结核病控制项目地区和非项目地区病人对首诊机构的选择,和首诊机构在结核病诊断和转诊中存在的问题。方法：对苏北结核病控制项目县(建湖县)和非项目县(阜宁县)2002年全年登记的493名新诊断结核病人进行问卷调查。结果：首次就诊直接去县结防所的病人比例仅为1％左右,首次就诊比例最高的机构为村诊所。项目县县市级医院和乡镇医院获得转诊的比例显著高于非项目县。结论：应着力于促使乡镇医院和县市医院及早对病人进行相应检查和及时转诊,完善转诊管理体系。

Objective： To compare the difference in health facility selection for first health care seeking in tuberculosis（TB） patients between counties with and without the National TB Control Program（NTP）. Method： A cross-sectional study of 493 newly diagnosed TB patients registered in the study sites during 2002 was conducted using a structured questionnaire. Results： The most frequently visited health facility was village health station. The referral rate of patients who were suspected as TB at their first hospital visits was higher in the programme county than that of the non-programme county. Conclusion： It is necessary to develop more sound TB convergence management system, to improve the effect of referral, and to enhance the capability and willingness of health providers on referral.