天津市三甲医院肺结核可疑者转诊未到位的相关因素分析

Analysis of factors on the failures in referring TB suspects from third grade class A hospital in Tianjin

目的分析转诊后未到位肺结核可疑者未到位原因,探讨进一步提高转诊到位率的措施。方法采用统一培训调查员,入户填写调查问卷方法对315例转诊后未就诊肺结核可疑症状者进行调查,使用SPSS10.0软件包进行统计分析。结果完成有效调查问卷181份,未就诊者多为低收入(94.1%)、低学历(80.7%)的社会弱势人群,已在其他医院就诊除外肺结核(54.5%)、自觉症状消失/好转(17.4%)、经济困难(6.6%)、行动不便(6.0%)、交通困难(4.8%)、药店自购药(4.2%)等为患者未就诊的主要原因。结论结核病防治专业机构加大工作的积极性和主动性、在全社会强化健康促进工作、特别是强化免费诊治政策的宣传,不断提高与医疗机构的合作程度、提高医务人员传染病报告卡填写质量,加强对抗结核药品的管理力度等措施以提高转诊患者的到位率。

Objective To analyze the causes for which the TB suspects who had been transferred, but did not arrive at TB control institute for clinical consultation, and to discuss the measure for improving the arrival rate of referral. Methods The trained investigators interviewed 315 TB suspects who did not go to TB control institute for clinical consultation after referring during family visits with questionnaire, SPSS 10.0 software was used to analyze the data. Results One hundred and eighty-one questionnaires were finished. Most cases were vulnerable group of low income （94.1%） and low education （80.7%）. The main reasons were that the suspects had been diagnosed as other diseases except TB in other hospitals （54. 5 %） ; the symptom had alleviated or healed （17.4%） ; with poor condition （6.6%）, mobility disabled （6.0%）, with poor traffic condition （4. 8%） ; the patients had bought TB drugs in drugstore （4.2%）. Conclusions By means of increasing the activity and initiative of TB institute, strengthening health promotion activities, especially propagandizing free diagnosis and treatment policy, improving the cooperation between TB dispensaries and hospitals, enhancing the quality of filling in infection card and strengthening management of TB drug, the arrival rate of referral will be improved.