浙江省海宁市结核病诊疗模式转变效果评价

THE EFFECT APPRAISAL OF TUBERCULOSIS DIAGNOSIS AND TREATMENT PATTERN TRANSFORMATION IN HAINING OF ZHEJIANG

[目的]探索由疾控机构将结核病临床归口治疗职能转移到综合性医疗单位,并通过强化结核病项目工作措施,落实项目各种责任和任务,实施督导检查和奖励制度,保持了结核病控制项目工作持续发展。[方法]转变结核病临床治疗模式,从原有的由市疾控中心承担对结核病人临床治疗调整为,通过综合性医疗单位承担结核病临床诊治工作,建立了由市疾控中心承担对病人的社会管理、市人民医院做好对结核病人治疗、其他医疗单位实施结核病转诊、督导管理的有效工作策略。[结果]全市新发涂阳肺结核病登记率2005年为34.53/10万,2006年为29.69/10万;涂阳肺结核病人治愈率2005年为88.10%,2006年为89.38%;转诊到位率2005年为95.50%,2006年为95.10%。[结论]通过结核病临床治疗模式的转变,全市结核病控制项目成绩继续得到保持,结核病各项工作指标没有明显改变继续保持高发现率、高治愈率、高管理率的状态。并充分运用结核病网络管理系统工作平台,为促进全市结核控制项目工作的发展创造了条件。

[Objective] To explore the shifts of tuberculosis clinical treatment function from CDC to comprehensive medical unit, and through strengthening tuberculosis project measure, make sure each kind of responsibility and duty of the project, carry out the direction inspection and incentive system, maintain the tuberculosis Control project work to continue developing. [ Methods] Transformed tuberculosis clinical treatment pattern from original CDC which undertook the tuberculosis Clinical diagnosis work to the Comprehensive medical unit for the tuberculosis patients＇ clinical treatment, and established the patients＇ social management undertaken by the CDC, completed the tuberculosis patient＇s treatment by the municipal peoples＇ hospital, implemented effective WOrk strategy on the tuberculosis patients＇ transfer treatment and the management by other medical units. [ Results] The new smear positive tuberculosis case registration rate in whole city was 34.53 per 100 thousand in 2005, was 29.69 per 100 thousand in 2006. The cure rate of smear positive tuberculosis patients was 88.10% in 2005, was 89.38% in 2006, and the achievement rate of transfer treatment Was 95.50% in 2005, was 95.10% in 2006. [Conclusion] Through the transformation of tuberculosis clinical treatment pattern, the results of tuberculosis control project in the whole city continue to maintain, the tuberculosis＇s each performance measure does not obviously change and continues to maintain the high discovery rate, high cure rate, and high management rate. And the fully utilizing tuberculosis network management system working platform creates the condition for promoting tuberculosis control project work development in the whole city.