中国农村地区医务人员肺结核报病奖励政策知晓率和满意度分析

Analysis on the awareness and satisfactory degree of health care providers towards the pulmonary tuberculosis case referral subsidy policy

目的:探讨中国农村地区医务人员对肺结核报病奖励政策的了解和满意程度,为政策的实施效果评价提供科学依据。方法:选取中国4个省的8个县区为研究现场,采用问卷调查方法调查不同工作层面的医务人员对报病奖励政策的知晓率和满意度,并分析其影响因素。结果:研究对象的报病奖励政策平均知晓率、正确应答率分别为85.8%和84.5%,不同级别医疗机构医务人员知晓率(P=0.022)、不同省份医务人员(P<0.001)知晓率差别有统计学意义;研究对象对政策总体满意度为80.9%,其中实施效果、奖励额度的满意度分别为80.7%和61.4%,两者差异有统计学意义(P<0.001)。地方筹资方式、医务人员的文化程度、工作层面和地区差异是影响政策满意度的因素。结论:中国结核病控制项目应当根据不同地区、不同级别医务人员的实际情况,适当调整、提高肺结核报病奖励额度,明确其分配方式,提高结核病人发现率。

Objective:This paper is to explore the awareness and satisfactory level of health workers towards the pulmonary TB case referral subsidy policy,so as to provide scientific evidence for the assessment of this policy. Methods:8 counties of 4 provinces were selected as study locations. Questionnaire investigation was conducted among health care providers involved in TB case referral process in different areas and with differences working levels to obtain their awareness rate and satisfactory rate towards the policy. Results:The average awareness rate and correct response rate of study subjects were 85.8% and 84.5% respectively. There were significant differences among different level health care providers(P=0.022)and different provinces (P<0.001). The general satisfactory rate of health care providers was 80.9%,while the satisfactory rates towards policy implementation and reward amount were 80.7% and 61.4% respectively. Local financing strategy,education level and working level of health workers,regional disparity were factors influencing the policy satisfactory rate. Conclusion:Chinese TB control program should adjust the subsidy amount and establish a proper distribution mechanism of TB case referral according to practical situations of health workers with different working levels and in different areas,as well as the financing ability of local government,so as to improve TB case detection rate.