福建省加强医防合作提高肺结核病人发现的探讨

Discussions on strengthening the cooperation between the general hospitals and TB dispensaries to improve the case-detection of pulmonary tuberculosis in Fujian province

目的探讨福建省综合医院与结防机构合作(简称"医防合作")开展肺结核病人转诊和追踪工作,提高病人发现的效果。方法制订卫生行政部门、综合医院、结防机构在肺结核病人转诊和追踪工作的职责与任务,通过卫生行政部门监督协调,综合医院报告转诊,结防机构检查、追踪与报表收集;数据采用SPSS11.0软件处理。结果55.5%的涂阳肺结核初诊病人来源于综合医院,明显高于其他类型来源(P<0.01);结防机构涂阳肺结核病人检出率明显高于综合医院;2004—2007年综合医院转诊到位率从42.8%到36.3%,结防机构追踪率从53.3%上升到95.2%,追踪到位率从53.4%上升到67.3%,总体到位率从59.1%上升到77.1%,(趋势χ2检验,P<0.01)。结论开展医防合作是提高肺结核病人发现的重要方式,但合作的机制有待进一步加强。

Objective To evaluate the effectiveness of TB case referring and tracing in the cooperation between general hospitals and TB dispensaries, and to improve the case detection of pulmonary tuberculosis. Methods Responsibilities and take of health administration, general hospitals and TB dispensaries, the department of health administration, general hospitals reported and referred tuberculosis patients. TB dispensaries developed tracing tuberculosis patients and collected the report forms. The data was analyzed by SPSS11.0. Results 55.5% new infectious pulmonary tuberculosis were reported by general hospitals which was significantly higher than other sources （P〈0.01）. The detection rate of infectious pulmonary tuberculosis by the TB dispensaries was significantly higher than general hospitals. From 2004 to 2007, the referring arrival rate was descended from 42.8% to 36.3% in general hospitals. The tracing rate increased from 53.3% to 95.2%, the tracing arrival rate increased from 53.4% to 67.3%, and the overall arrival rate rose from 59.1% to 77. 1% in TB dispensaries. The indexes have been increasing each year except for the referring arrival rate （Current chi-square test, P〈0.01）. Conclusions It was an important methed to impove the case detection by the cooperation between general hospitals and TB dispensaries, but the cooperation mechanism would be strengthened.