肺结核病人转诊和追踪及医务人员奖励政策的定性研究

A qualitative study on pulmonary tuberculosis case referral and tracing policy related incentive measures to healthcare providers

目的:探讨肺结核病人转诊追踪及相关奖励政策在实施过程中的问题及影响病人发现的因素。方法选取中国不同地区、不同工作层面的结核病防治人员开展焦点组访谈。结果:理解误区、转诊不到位、利益冲突、宣传力度不足等因素制约着病人的发现,偏低的奖励额度在一定程度上影响了医务人员的热情和积极性。结论:需要充分考虑医防结合模式下各级结防人员的投入与需求,针对不同地区的实际情况采取合适的激励措施,以促进结核病人的发现。

Objective： To find out difficulties and problems encountered in the implementation of TB case referral and tracing policy, as well as the incentive measures towards healthcare providers, and to explore risk factors constraining the patient detection. Methods： Focus group discussion were applied among part of anti-TB staff of different working levels in China. Results： Misconception, referral failure, lack of advertising and conflict of interest etc. were risk factors circumscribing the patient detection. Relatively low incentive amount to some extent damaged the enthusiasm of healthcare providers. Conclusion： The input and demand of anti-TB staff in different working levels should be taken into consideration based on the clinic-prevention mix model. In order to improve TB case detection, proper incentive measures should be implemented according to practical situations in different areas.