山东省农村肺结核患者求医行为研究

Health seeking behavior of rural tuberculosis patients in Shandong Province

目的分析农村肺结核患者的求医行为。方法随机选择山东省的3个县,通过面对面问卷方式,调查了247名在县结核病防治所登记的新发涂阳农村肺结核患者。结果近75%的农村肺结核患者在到县结核病防治所接受免费抗结核治疗前,至少去过2家卫生机构。有58%的患者在有症状后首先到村卫生室就诊,但75%的患者被错误地诊断为感冒。从村卫生室到县医院,再到县结核病防治所;从县医院到县结核病防治所;从村卫生室到乡镇卫生院,再到县结核病防治所是主要的就医行为模式。结论农村肺结核患者需要多次就诊才能获得正规抗结核服务,但首诊机构是村卫生室的患者,其就诊过程要更为复杂。

Objective To explore the health seeking behavior of rural tuberculosis（TB） patients in Shandong Province.Methods Three counties in Shandong Province were selected as study sites,and a total of 247 new smear-positive rural patients registered in the county TB dispensary were interviewed using a structured questionnaire.Results Nearly 75% of rural TB patients visited at least two healthcare providers before they went to the county TB dispensary.58% of TB patients made the village clinic the health institution of choice in the health-seeking process,of which 75% were initially diagnosed as having a cold.From village clinic to county hospital then to county TB dispensary,from county hospital to county TB dispensary,and from village clinic to township health center then to county TB dispensary are the main health seeking models.Conclusion Rural TB patients have to go to many health institutions before they get standard anti-TB treatment.Visiting the village clinic first results in a more complex health-seeking process.