目标考核对提高肺结核病人转诊和追踪效果的评价

Evaluation on the results of target assessment in enhancement of referral and tracing of pulmonary tuberculosis cases

目的了解湖北省肺结核病人转诊和追踪工作实施的进展和效果。方法将肺结核病人转诊和追踪工作纳入各市州政府结核病防治工作目标责任书考核内容，每半年现场考评1次，同时抽查市、县级综合医院肺结核疫情登记、报告和转诊情况，以及结防专业机构对网络直报病人的追踪情况。考评资料经审核后；12总，采用SAS8．1软件处理。结果实施目标考核1年后，市级综合医院肺结核疫情报告率由71．1％提高到92，1％（P〈0．01），转诊率由36．3％提高到81．3％（P〈0．0001）。县级综合医院报告率由65．5％提高到97．2％（P〈0．001），转诊率由47．5％提高到94．9％（P〈0.0001）。全省结防机构追踪率由78．6％提高到92．2％（P〈0．0001），追踪到位率45．9％。2006年1—6月，全省由转诊和追踪发现的肺结核病人数，占病人发现总数的34．2％。结论实施目标考核后，有力促进医疗机构和结防机构之间的协调与合作，极大地提高病人的发现。

Objective To understand the progress and reasults of referral and tracing for TB suspects in Hubei Province. Methods The progress of referral and tracing for TB suspects was assessed by provincial government in the field once half a year after target management implemented since 2005. One general hospital and one TB dispensary were involved in the check respectively at city and county level. The assessment data were rechecked and analyzed with SAS 8.1. Results One year after target management implemented, the notification rates of TB suspects increased from 71.1% to 92.1% in municipal hospital （ P 〈 0.01） ,and from 65. 5% to 97.2% in county hospital （ P 〈 0.001 ）. The referral rates enhanced from 36.3% to 81.3% in city hospital （ P 〈 0.0001 ）, and from 47.5% to 94.9% in county hospital （P 〈 0.0001）. The tracing rate increased from 78.6% to 92.2% （ P 〈 0.0001）, and the tracing success rate was 45.9%. 34.2% of the total TB cases detected during the first half year of 2006 was attributed to referral and tracing. Conclusion The cooperation and collaboration between general hospital and TB dispensary have been strengthened significantly after implementation of TB target management. The case - finding rate has been obviously enhanced throughout the province.